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Preoperative nutritional support in patients undergoing pancreatic surgery affects PREPARE score accuracy

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61989592%3A15110%2F23%3A73621909" target="_blank" >RIV/61989592:15110/23:73621909 - isvavai.cz</a>

  • Alternative codes found

    RIV/00098892:_____/23:10158285

  • Result on the web

    <a href="https://www.frontiersin.org/articles/10.3389/fsurg.2023.1275432/full" target="_blank" >https://www.frontiersin.org/articles/10.3389/fsurg.2023.1275432/full</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.3389/fsurg.2023.1275432" target="_blank" >10.3389/fsurg.2023.1275432</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Preoperative nutritional support in patients undergoing pancreatic surgery affects PREPARE score accuracy

  • Original language description

    Background: This study aimed to validate the accuracy of the PreoperativePancreatic Resection (PREPARE) risk score in pancreatic resection patients.Patients and methods: This prospective study included 216 patients who underwentpancreatic resection between January 2015 and December 2018. All patients in ourcohort with weight loss or lack of appetite received dietary advice and preoperativeoral nutritional supplementation (600 kcal/day). Demographic, clinicopathological,operative, and postoperative data were collected prospectively. The PREPAREscore and the predicted risk of major complications were computed for eachpatient. Differences in major postoperative complications were analyzed using amultivariate Cox proportional hazards regression model. The predicted andobserved risks of major complications were tested using the C-statistic.Results: The study included 216 patients [117 men (54.2%)] with a median age of65.0 (30.0–83.0) years. The majority of patients were classified as AmericanSociety of Anesthesiologists (ASA)’ Physical Status score II (N = 164/216; 75.9%)and as “low risk” PREPARE score (N = 185/216; 85.6%) before the surgery. Only 4(1.9%) patients were malnourished, with albumin levels of less than 3.5 g/dl. Themost common type of pancreatic resection was a pylorus-preservingpancreaticoduodenectomy (N = 122/216; 56.5%). Major morbidity and 30-daymortality rates were 11.1% and 1.9%, respectively. The type of surgical procedure(hazard ratio [HR]: 3.849; 95% confidence interval [CI]: 1.208–12.264) and ASAscore (HR: 3.089; 95% CI: 1.067–8.947) were significantly associated with theincidence of major postoperative complications in multivariate analysis. Thereceiver operating characteristic curve was 0.657 for incremental values and0.559 for risk categories, indicating a weak predictive model.Conclusion: The results of the present study suggest that the PREPARE risk scorehas low accuracy in predicting the risk of major complications in patients withconsistent preoperative nutritional support. This limits the use of PREPARE riskscore in future preoperative clinical routines.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30212 - Surgery

Result continuities

  • Project

  • Continuities

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Others

  • Publication year

    2023

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Frontiers in Surgery

  • ISSN

    2296-875X

  • e-ISSN

    2296-875X

  • Volume of the periodical

    10

  • Issue of the periodical within the volume

    November 2023

  • Country of publishing house

    CH - SWITZERLAND

  • Number of pages

    7

  • Pages from-to

    1275432

  • UT code for WoS article

    001104281200001

  • EID of the result in the Scopus database

    999