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https://hdl.handle.net/2440/140258
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Type: | Journal article |
Title: | Risk Nomogram Does Not Predict Anastomotic Leakage After Colon Surgery Accurately: Results of the Multi-center LekCheck Study |
Author: | Ozmen, I. Grupa, V.E.M. Bedrikovetski, S. Dudi Venkata, N.N. Huisman, D.E. Reudink, M. Slooter, G.D. Sammour, T. Kroon, H.M. Daams, F. |
Citation: | Journal of Gastrointestinal Surgery, 2022; 26(4):900-910 |
Publisher: | Springer |
Issue Date: | 2022 |
ISSN: | 1091-255X 1873-4626 |
Statement of Responsibility: | Izel Ozmen, Vera E. M. Grupa, Sergei Bedrikovetski, Nagendra N. Dudi‑Venkata, Daitlin E. Huisman, Muriël Reudink, Gerrit D. Slooter, Tarik Sammour, Hidde M. Kroon, Freek Daams on behalf of the LekCheck Study Group |
Abstract: | Purpose: Anastomotic leakage (AL) is a dreaded complication after colorectal surgery. Preoperatively identifying high-risk patients can help to reduce the incidence of this complication. For this reason, AL risk nomograms have been developed. The objective of this study was to test the AL risk nomogram developed by Frasson, et al. for validity and to identify riskfactors for AL. Methods: From the international multi-center LekCheck study database, patients who underwent colonic surgery with the formation of an anastomosis were included. Data were prospectively collected between 2016 and 2019 at 14 hospitals. Univariate and multivariable regression analyses, and area under receiver operating characteristic curve analysis (AUROC) were performed. Results: A total of 643 patients were included. The median age was 70 years and 51% were male. The majority underwent surgery for malignancies (80.7%). The overall AL rate was 9.2%. The risk nomogram was not predictive for AL in the population tested (AUROC 0.572). Low preoperative haemoglobin (p = 0.006), intraoperative hypothermia (p = 0.02), contamination of the operative field (p = 0.004), and use of epidural analgesia (p = 0.02) were independent risk-factors for AL. Conclusion: The AL risk nomogram could not be validated using the international LekCheck study database. In the future, intraoperative predictive factors for AL, as identified in this study, should also be included in AL risk predictors. |
Keywords: | Colonic surgery; Colon cancer; Anastomotic leakage; Risk score validation |
Description: | Published online: 8 January 2022 |
Rights: | © The Society for Surgery of the Alimentary Tract 2021 |
DOI: | 10.1007/s11605-021-05119-6 |
Published version: | http://dx.doi.org/10.1007/s11605-021-05119-6 |
Appears in Collections: | Surgery publications |
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