Background: Postoperative complications after pancreatectomy are a challenging problem due to their high incidence and serious consequences. The majority of studies have focused on a specific complication, but data on predictors of overall postoperative complications (OPCs) are limited. Methods: The data of patients who underwent pancreatectomy at a single institute between 2017 and 2019 were analyzed retrospectively. Univariate and multivariate logistic regression were used to investigate predictors of the outcomes of interest. The Clavien-Dindo classification and comprehensive complication index (CCI) were used to assess postoperative complications and the severity of postoperative complications. The relationship between predictors and the CCI was evaluated by linear regression. Results: A total of 490 patients were divided into a training group (n = 339) and a validation group (n = 151). The rate of OPCs was 44.25%. Fluid transfusion and albumin difference (AD) were predictors of OPCs. AD showed a good discrimination (AUC = 0.70) and good calibration in the validation cohort. AD was associated with complications, including pancreatic fistula, intra-abdominal hemorrhage, intra-abdominal infection, delayed gastric emptying, and re-intervention, and was positively correlated with complication severity. Intraoperative blood loss and preoperative albumin were independent predictors of AD. Conclusions: AD, a variable that reflects dynamic physiological changes is a new and accessible predictor of OPCs following pancreatectomy.
Dig Surg

中文翻译：

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白蛋白差异作为胰腺切除术后并发症的新预测指标

背景：胰腺切除术后并发症的发生率高，后果严重，是一个具有挑战性的问题。大多数研究都集中在特定的并发症上，但关于整体术后并发症 (OPC) 预测因素的数据有限。方法：回顾性分析2017-2019年在单一机构接受胰腺切除术的患者资料。使用单变量和多变量逻辑回归来研究感兴趣的结果的预测因素。采用Clavien-Dindo分级和综合并发症指数（CCI）评估术后并发症和术后并发症的严重程度。通过线性回归评估预测因子和 CCI 之间的关系。结果：共490例患者分为训练组（ n =339）和验证组（ n =151）。OPCs 率为 44.25%。输液和白蛋白差异 (AD) 是 OPCs 的预测因子。AD 在验证队列中表现出良好的辨别力 (AUC = 0.70) 和良好的校准。AD与胰瘘、腹腔内出血、腹腔内感染、胃排空延迟和再干预等并发症相关，并与并发症严重程度呈正相关。术中失血量和术前白蛋白是 AD 的独立预测因子。结论：AD 是一个反映动态生理变化的变量，是胰腺切除术后 OPCs 的一个新的且易于使用的预测指标。
挖掘手术