TY - JOUR
T1 - Visceral adipose tissue is a better predictor than BMI in the alternative Fistula Risk Score in patients undergoing pancreatoduodenectomy
AU - Lucassen, Claudia J.
AU - Groen, Jesse V.
AU - Aziz, M. Hosein
AU - Bastiaannet, Esther
AU - Bonsing, Bert A.
AU - Leistra, Eva
AU - Shahbazi Feshtali, Shirin
AU - Vahrmeijer, Alexander L.
AU - Droop, Anneke
AU - Mieog, J. Sven D.
N1 - Publisher Copyright:
© 2022 The Author(s)
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background: Muscle attenuation (MA) and visceral adipose tissue (VAT) have not yet been included in the currently used alternative Fistula Risk Score (a-FRS). The aim of this study was to examine the added value of these parameters as predictors of clinically relevant postoperative pancreatic fistula (CR-POPF) in the a-FRS after pancreatoduodenectomy compared to Body Mass Index (BMI). Methods: A single center retrospective cohort study was performed in patients who underwent pancreatoduodenectomy between 2009 and 2018. The a-FRS model was reproduced, MA and VAT were both combined and separately added to the model instead of BMI using logistic regression analysis. Model discrimination was assessed by ROC-curves. Results: In total, 329 patients were included of which 55 (16.7%) developed CR-POPF. The a-FRS model showed an AUC of 0.74 (95%CI: 0.68–0.80). In this model, BMI was not significantly associated with CR-POPF (p = 0.16). The MA + VAT model showed an AUC of 0.81 (95%CI: 0.75–0.86). VAT was significantly associated with CR-POPF (per cm2, OR: 1.01; 95%CI: 1.00–1.01; p < 0.001). The AUC of the MA + VAT model differed significantly from the AUC of the a-FRS model (p = 0.001). Conclusion: Visceral adipose tissue is of added value in the a-FRS compared to BMI in predicting CR-POPF in patients undergoing pancreatoduodenectomy.
AB - Background: Muscle attenuation (MA) and visceral adipose tissue (VAT) have not yet been included in the currently used alternative Fistula Risk Score (a-FRS). The aim of this study was to examine the added value of these parameters as predictors of clinically relevant postoperative pancreatic fistula (CR-POPF) in the a-FRS after pancreatoduodenectomy compared to Body Mass Index (BMI). Methods: A single center retrospective cohort study was performed in patients who underwent pancreatoduodenectomy between 2009 and 2018. The a-FRS model was reproduced, MA and VAT were both combined and separately added to the model instead of BMI using logistic regression analysis. Model discrimination was assessed by ROC-curves. Results: In total, 329 patients were included of which 55 (16.7%) developed CR-POPF. The a-FRS model showed an AUC of 0.74 (95%CI: 0.68–0.80). In this model, BMI was not significantly associated with CR-POPF (p = 0.16). The MA + VAT model showed an AUC of 0.81 (95%CI: 0.75–0.86). VAT was significantly associated with CR-POPF (per cm2, OR: 1.01; 95%CI: 1.00–1.01; p < 0.001). The AUC of the MA + VAT model differed significantly from the AUC of the a-FRS model (p = 0.001). Conclusion: Visceral adipose tissue is of added value in the a-FRS compared to BMI in predicting CR-POPF in patients undergoing pancreatoduodenectomy.
UR - http://www.scopus.com/inward/record.url?scp=85129696068&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2022.03.004
DO - 10.1016/j.hpb.2022.03.004
M3 - Article
C2 - 35527105
AN - SCOPUS:85129696068
SN - 1365-182X
VL - 24
SP - 1679
EP - 1687
JO - HPB
JF - HPB
IS - 10
ER -