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

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00098892:_____/23:10158285

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30212 - Surgery

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2023

Kód důvěrnosti údajů

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

Název periodika

Frontiers in Surgery

ISSN

2296-875X

e-ISSN

2296-875X

Svazek periodika

10

Číslo periodika v rámci svazku

November 2023

Stát vydavatele periodika

CH - Švýcarská konfederace

Počet stran výsledku

7

Strana od-do

1275432

Kód UT WoS článku

001104281200001

EID výsledku v databázi Scopus

999