Kantor et al reported a modified fistula risk score for a patient undergoing pancreaticoduodenectomy. This score is a modification of the Fistula Risk Score (FRS) of Callery et al. The authors are from multiple institutions in the United States.
Patient selection: pancreaticoduodenectomy
Outcome: clinically-relevant pancreatic fistula
Parameter:
(1) sex
(2) body mass index (BMI) in kg per square meter
(3) serum total bilirubin in mg/dL
(4) pancreatic duct diameter in mm
(5) pancreatic gland texture
Parameter
Finding
Point
sex
female
0
male
2
BMI
< 25
0
>= 25
1
total bilirubin
>= 2
0
< 2
1
duct diameter
< 3 mm
4
3 to 6 mm
3
> 6 mm
0
pancreatic texture
soft
2
firm or intermediate
0
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the risk of a clinically-relevant post-operative pancreatic fistula.
Score
Risk Category
Percent Fistula
0 to 2
negligible
0%
3 to 6
low
< 10%
7 or 8
intermediate
10-20%
9 or 10
high
> 20%
Performance:
• The area under the ROC curve is 0.70.
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