BACKGROUND Previous studies analyzed risk factors for postoperative pancreatic fistula (POPF) and developed risk prediction tool using scoring system. However, no study has built a nomogram based on individual risk factors. This study aimed to evaluate individual risks of POPF and propose a nomogram for predicting POPF. METHODS From 2007 to 2016, medical records of 1771 patients undergoing pancreaticoduodenctomy were reviewed retrospectively. Variables with p < 0.05 in multivariate logistic regression analysis were included in the nomogram. Internal performance validation was executed using a repeated cross validation method. RESULTS Of 1771 patients, 222 (12.5%) experienced POPF. In multivariable analysis, sex (p = 0.004), body mass index (BMI) (p < 0.001), ASA score (p = 0.039), preoperative albumin (p = 0.035), pancreatic duct diameter (p = 0.002), and location of tumor (p < 0.001) were identified as independent predictors for POPF. Based on these six variables, a POPF nomogram was developed. The area under the curve (AUC) estimated from the receiver operating characteristic (ROC) graph was 0.709 in the train set and 0.652 in the test set. CONCLUSIONS A POPF nomogram was developed. This nomogram may be useful for selecting patients who need more intensified therapy and establishing customized treatment strategy.

中文翻译：

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用诺法图预测术后胰瘘。

背景技术先前的研究分析了术后胰瘘（POPF）的危险因素，并使用评分系统开发了风险预测工具。但是，尚无研究基于个体风险因素建立列线图。这项研究旨在评估POPF的个体风险，并提出用于预测POPF的诺模图。方法回顾性分析2007年至2016年接受胰十二指肠切除术的1771例患者的病历。诺模图中包括在多元逻辑回归分析中p <0.05的变量。使用重复的交叉验证方法执行内部性能验证。结果在1771名患者中，有222名（12.5％）经历了POPF。在多变量分析中，性别（p = 0.004），体重指数（BMI）（p <0.001），ASA评分（p = 0.039），术前白蛋白（p = 0.035），胰管直径（p = 0.002）和肿瘤位置（p <0.001）被确定为POPF的独立预测因子。基于这六个变量，开发了POPF列线图。根据接收机工作特性（ROC）图估算出的曲线下面积（AUC）在列车组中为0.709，在测试组中为0.652。结论开发了POPF列线图。该诺模图对于选择需要更多强化治疗的患者和建立定制的治疗策略可能有用。结论开发了POPF列线图。该诺模图对于选择需要更多强化治疗的患者和建立定制的治疗策略可能有用。结论开发了POPF列线图。该诺模图对于选择需要更多强化治疗的患者和建立定制的治疗策略可能有用。