Evidence map›Paper›PMID 38114826›Full record

ArticleLangenbeck's archives of surgery2023

Nationwide validation of the distal fistula risk score (D-FRS).

Eduard A van Bodegraven, Femke E T den Haring, Britt Pollemans, Damaris Monselis, Matteo De Pastena, Casper van Eijck, Freek Daams, Ignace de Hingh, Misha Luyer, Martijn W J Stommel and 13 more

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Article in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Eduard A van BodegravenDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, De Boelelaan 1117 (ZH-7F), 1081, HV, Amsterdam, the Netherlands.
Femke E T den HaringDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, De Boelelaan 1117 (ZH-7F), 1081, HV, Amsterdam, the Netherlands.
Britt PollemansDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, De Boelelaan 1117 (ZH-7F), 1081, HV, Amsterdam, the Netherlands.
Damaris MonselisDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, De Boelelaan 1117 (ZH-7F), 1081, HV, Amsterdam, the Netherlands.
Matteo De PastenaGeneral and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy.
Casper van EijckDepartment of Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
Freek DaamsDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, De Boelelaan 1117 (ZH-7F), 1081, HV, Amsterdam, the Netherlands.
Ignace de HinghDepartment of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
Misha LuyerDepartment of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
Martijn W J StommelDepartment of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
Hjalmar C van SantvoortDepartment of Surgery, Regional Academic Cancer Center Utrecht (RAKU), Utrecht, the Netherlands.
S FestenDepartment of Surgery, OLVG, Amsterdam, the Netherlands.
J S D MieogDepartment of Surgery, LUMC, Leiden, the Netherlands.
J KlaaseDepartment of Surgery, University Medical Center Groningen, Groningen, the Netherlands.
D LipsDepartment of Surgery, Medisch Spectrum Twente, Enschede, the Netherlands.
M M E CoolsenDepartment of Surgery, Maastricht Universitair Medisch Centrum, Maastricht, the Netherlands.
G P van der SchellingDepartment of Gastroenterology and Hepatology, Amphia Hospital, Breda, the Netherlands.
E R ManusamaDepartment of Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
G PatijnDepartment of Surgery, Isala Clinics, Zwolle, the Netherlands.
E van der HarstDepartment of Surgery, Maasstad Hospital, Rotterdam, the Netherlands.
K BosschaDepartment of Surgery, Jeroen Bosch Hospital, Den Bosch, the Netherlands.
Giovanni MarchegianiGeneral and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy.
Marc G BesselinkDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, De Boelelaan 1117 (ZH-7F), 1081, HV, Amsterdam, the Netherlands. m.g.besselink@amsterdamUMC.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDistal pancreatectomy (DP) is associated with a high complication rate of 30-50% with postoperative pancreatic fistula (POPF) as a dominant contributor. Adequate risk estimation for POPF enables surgeons to use a tailor-made approach. Assessment of the risk of POPF prior to DP can lead to the application of preventive strategies. The current study aims to validate the recently published preoperative and intraoperative distal fistula risk score (D-FRS) in a nationwide cohort.

methodsThis nationwide retrospective Dutch cohort study included all patients after DP for any indication, all of whom were registered in the Dutch Pancreatic Cancer Audit (DPCA) database between 2013 and 2021. The D-FRS was validated by filling in the probability equations with data from this cohort. The predictive capacity of the models was represented by an area under the receiver operating characteristic (AUROC) curve.

resultsA total of 896 patients underwent DP of which 152 (17%) developed POPF of whom 144 grade B (95%) and 8 grade C (5%). The preoperative D-FRS, consisting of the variables pancreatic neck thickness and pancreatic duct diameter, showed an AUROC of 0.73 (95%CI 0.68-0.78). The intraoperative D-FRS, comprising pancreatic neck, duct diameter, BMI, operating time, and soft pancreatic aspect, showed an AUROC of 0.69 (95%CI 0.64-0.74).

conclusionThe current study is the first nationwide validation of the preoperative and intraoperative D-FRS showing acceptable distinguishing capacity for only the preoperative D-FRS for POPF. Therefore, the preoperative score could improve prevention and mitigation strategies such as drain management, which is currently investigated in the multicenter PANDORINA trial.

Indexed as

PancreasPancreatic FistulaCohort StudiesHumansPancreatectomyPancreaticoduodenectomyPostoperative ComplicationsRetrospective StudiesRisk AssessmentRisk FactorsDistal fistula risk scoreDistal pancreatectomyPostoperative pancreatic fistula

Identifiers

PMID38114826

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.