External validation of postoperative pancreatic fistula prediction scores in pancreatoduodenectomy: a systematic review and meta-analysis.

Autor:	Pande R; Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK. Electronic address: rupaly.pande@uhb.nhs.uk., Halle-Smith JM; Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK., Phelan L; Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK., Thorne T; Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK., Panikkar M; Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK., Hodson J; Institute of Translational Medicine, Queen Elizabeth Hospital, Birmingham, UK., Roberts KJ; Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK., Arshad A; Hepatobiliary and Pancreatic Surgery Unit, University Hospital of Southampton, Tremona Rd, Southampton, SO16 6YD, UK., Connor S; Department of General Surgery, Christchurch Hospital, 2 Riccarton Ave, Christchurch, 8140, New Zealand., Conlon KC; Hepatobiliary and Pancreatic Surgery Unit, The University of Dublin, Trinity College, College Green, Dublin 2, Ireland., Dickson EJ; Hepatobiliary and Pancreatic Surgery Unit, Glasgow Royal Infirmary, Scotland, UK., Giovinazzo F; General Surgery and Liver Transplantation Unit, Policlinico Universitario Agostino Gemelli, Rome, Italy., Harrison E; Centre for Medical Informatics, Usher Institute, University of Edinburgh, EH16 4UX, UK., de Liguori Carino N; Hepatobiliary and Pancreatic Surgery Unit, Manchester University NHS FT, Manchester, M13 9WL, UK., Hore T; Department of General Surgery, Christchurch Hospital, 2 Riccarton Ave, Christchurch, 8140, New Zealand., Knight SR; Centre for Medical Informatics, Usher Institute, University of Edinburgh, EH16 4UX, UK., Loveday B; Hepatobiliary and Pancreatic Surgery Unit, Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3052, Australia., Magill L; Birmingham Surgical Trials Consortium (BiSTC), University of Birmingham, Birmingham, B15 2TW, UK., Mirza D; Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK., Pandanaboyana S; HPB and Transplant Surgery, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, UK., Perry RJ; Birmingham Surgical Trials Consortium (BiSTC), University of Birmingham, Birmingham, B15 2TW, UK., Pinkney T; Birmingham Surgical Trials Consortium (BiSTC), University of Birmingham, Birmingham, B15 2TW, UK., Siriwardena AK; Hepatobiliary and Pancreatic Surgery Unit, Manchester University NHS FT, Manchester, M13 9WL, UK., Satoi S; Division of Pancreatobiliary Surgery, Kansai Medical University, Osaka, Japan; Division of Surgical Oncology, University of Colorado Anschutz Medical,Campus, Aurora, CO, USA., Skipworth J; Hepatobiliary and Pancreatic Surgery Unit, University Hospitals Bristol NHS Foundation Trust, Marlborough Street, Bristol, BS1 3NU, UK., Stättner S; Hepatobiliary and Pancreatic Surgery Unit, Salzkammergut Klinikum OÖG, Sweden., Sutcliffe RP; Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK., Tingstedt B; Hepatobiliary and Pancreatic Surgery Unit, Lund University, Box 117, 221 00, Lund, Sweden.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2022 Mar; Vol. 24 (3), pp. 287-298. Date of Electronic Publication: 2021 Nov 02.
DOI:	10.1016/j.hpb.2021.10.006
Abstrakt:	Background: Multiple risk scores claim to predict the probability of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy. It is unclear which scores have undergone external validation and are the most accurate. The aim of this study was to identify risk scores for POPF, and assess the clinical validity of these scores. Methods: Areas under receiving operator characteristic curve (AUROCs) were extracted from studies that performed external validation of POPF risk scores. These were pooled for each risk score, using intercept-only random-effects meta-regression models. Results: Systematic review identified 34 risk scores, of which six had been subjected to external validation, and so included in the meta-analysis, (Tokyo (N=2 validation studies), Birmingham (N=5), FRS (N=19), a-FRS (N=12), m-FRS (N=3) and ua-FRS (N=3) scores). Overall predictive accuracies were similar for all six scores, with pooled AUROCs of 0.61, 0.70, 0.71, 0.70, 0.70 and 0.72, respectively. Considerably heterogeneity was observed, with I2 statistics ranging from 52.1-88.6%. Conclusion: Most risk scores lack external validation; where this was performed, risk scores were found to have limited predictive accuracy. . Consensus is needed for which score to use in clinical practice. Due to the limited predictive accuracy, future studies to derive a more accurate risk score are warranted. (Copyright © 2021. Published by Elsevier Ltd.)
Databáze:	MEDLINE
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