Preoperative Pancreatic Resection (PREPARE) score: a prospective multicenter-based morbidity risk score
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Preoperative Pancreatic Resection (PREPARE) score: a prospective multicenter-based morbidity risk score. / Uzunoglu, Faik G; Reeh, Matthias; Vettorazzi, Eik; Ruschke, Till; Hannah, Philipp; Nentwich, Michael F; Vashist, Yogesh K; Bogoevski, Dean; König, Alexandra; Janot, Monika; Gavazzi, Francesca; Zerbi, Alessandro; Todaro, Valentina; Malleo, Giuseppe; Uhl, Waldemar; Montorsi, Marco; Bassi, Claudio; Izbicki, Jakob R; Bockhorn, Maximilian.
In: ANN SURG, Vol. 260, No. 5, 01.11.2014, p. 857-64.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Preoperative Pancreatic Resection (PREPARE) score: a prospective multicenter-based morbidity risk score
AU - Uzunoglu, Faik G
AU - Reeh, Matthias
AU - Vettorazzi, Eik
AU - Ruschke, Till
AU - Hannah, Philipp
AU - Nentwich, Michael F
AU - Vashist, Yogesh K
AU - Bogoevski, Dean
AU - König, Alexandra
AU - Janot, Monika
AU - Gavazzi, Francesca
AU - Zerbi, Alessandro
AU - Todaro, Valentina
AU - Malleo, Giuseppe
AU - Uhl, Waldemar
AU - Montorsi, Marco
AU - Bassi, Claudio
AU - Izbicki, Jakob R
AU - Bockhorn, Maximilian
PY - 2014/11/1
Y1 - 2014/11/1
N2 - OBJECTIVES: Development of a simple preoperative risk score to predict morbidity related to pancreatic surgery.BACKGROUND: Pancreatic surgery is standardized with little technical diversity among institutions and unchanging morbidity and mortality rates in recent years. Preoperative identification of high-risk patients is potentially one of the rare avenues for improving the clinical course of patients undergoing pancreatic surgery.METHODS: Using a prospectively collected multicenter database of patients undergoing pancreatic surgery (n=703), surgical complications were classified according to the Clavien-Dindo classification. A new scoring system for preoperative identification of high-risk patients that included only objective preoperatively assessable variables was developed using a multivariate regression model. Subsequently, this scoring system was prospectively validated from 2011 to 2013 (n=429) in a multicenter setting.RESULTS: Eight independent preoperatively assessable variables were identified and included in the scoring system: systolic blood pressure, heart rate, hemoglobin level, albumin level, ASA (American Society of Anesthesiologists) score, surgical procedure, elective surgery or not, and disease of pancreatic origin or not. On the basis of 3 subgroups (low risk, intermediate risk, high risk), the proposed scoring system reached an accuracy of 75% for correctly predicting occurrence or nonoccurrence of major surgical complications in 80% of all analyzed patients within the validation cohort (c-statistic index=0.709, P<0.001, 95% confidence interval=0.657-0.760).CONCLUSIONS: We present an easily applied scoring system with convincing accuracy for identifying low-risk and high-risk patients. In contrast to other systems, the score is exclusively based on objective preoperatively assessable characteristics and can be rapidly and easily calculated.
AB - OBJECTIVES: Development of a simple preoperative risk score to predict morbidity related to pancreatic surgery.BACKGROUND: Pancreatic surgery is standardized with little technical diversity among institutions and unchanging morbidity and mortality rates in recent years. Preoperative identification of high-risk patients is potentially one of the rare avenues for improving the clinical course of patients undergoing pancreatic surgery.METHODS: Using a prospectively collected multicenter database of patients undergoing pancreatic surgery (n=703), surgical complications were classified according to the Clavien-Dindo classification. A new scoring system for preoperative identification of high-risk patients that included only objective preoperatively assessable variables was developed using a multivariate regression model. Subsequently, this scoring system was prospectively validated from 2011 to 2013 (n=429) in a multicenter setting.RESULTS: Eight independent preoperatively assessable variables were identified and included in the scoring system: systolic blood pressure, heart rate, hemoglobin level, albumin level, ASA (American Society of Anesthesiologists) score, surgical procedure, elective surgery or not, and disease of pancreatic origin or not. On the basis of 3 subgroups (low risk, intermediate risk, high risk), the proposed scoring system reached an accuracy of 75% for correctly predicting occurrence or nonoccurrence of major surgical complications in 80% of all analyzed patients within the validation cohort (c-statistic index=0.709, P<0.001, 95% confidence interval=0.657-0.760).CONCLUSIONS: We present an easily applied scoring system with convincing accuracy for identifying low-risk and high-risk patients. In contrast to other systems, the score is exclusively based on objective preoperatively assessable characteristics and can be rapidly and easily calculated.
KW - Aged
KW - Aged, 80 and over
KW - Female
KW - Germany
KW - Humans
KW - Intraoperative Care
KW - Italy
KW - Male
KW - Middle Aged
KW - Pancreatic Diseases
KW - Postoperative Complications
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Risk Assessment
KW - Treatment Outcome
U2 - 10.1097/SLA.0000000000000946
DO - 10.1097/SLA.0000000000000946
M3 - SCORING: Journal article
C2 - 25243549
VL - 260
SP - 857
EP - 864
JO - ANN SURG
JF - ANN SURG
SN - 0003-4932
IS - 5
ER -
