TY - JOUR
T1 - Risk Nomogram Does Not Predict Anastomotic Leakage After Colon Surgery Accurately
T2 - Results of the Multi-center LekCheck Study
AU - LekCheck Study Group
AU - Ozmen, Izel
AU - Grupa, Vera E M
AU - Bedrikovetski, Sergei
AU - Dudi-Venkata, Nagendra N
AU - Huisman, Daitlin E
AU - Reudink, Muriël
AU - Slooter, Gerrit D
AU - Sammour, Tarik
AU - Kroon, Hidde M
AU - Daams, Freek
N1 - Funding Information: IO and VEMG were personally supported by the Stichting Prof. Michaël-van Vloten Fonds, Dr. Edith Frederiksfonds, LUSTRA + Scholarship (Leiden University) and DOO International Office Scholarship (Leiden University Medical Center). Publisher Copyright: © 2021, The Society for Surgery of the Alimentary Tract.
PY - 2022/4
Y1 - 2022/4
N2 - 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 risk-factors 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.
AB - 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 risk-factors 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.
KW - Anastomotic leakage
KW - Colon cancer
KW - Colonic surgery
KW - Risk score validation
UR - http://www.scopus.com/inward/record.url?scp=85122690890&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s11605-021-05119-6
DO - https://doi.org/10.1007/s11605-021-05119-6
M3 - Article
C2 - 34997466
SN - 1091-255X
VL - 26
SP - 900
EP - 910
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 4
ER -