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Development and validation of a multivariable prediction model in open abdomen patients for entero-atmospheric fistula.


ABSTRACT:

Background

Laparostomy or Open Abdomen (OA) has matured into an effective strategy in the management of abdominal catastrophe. Single prognostic factors have been identified in a previous systematic review regarding entero-atmospheric fistula (EAF). Unfortunately, no prognostic multivariable model for EAF exist. The aim was to develop and validate a multivariable prediction model from a retrospective cohort study involving three hospital's databases.

Methods

Fifty-seven variables were evaluated to develop a multivariable model. Univariate and multivariable logistic regression analyses were performed for on a developmental data set from two hospitals. Receiver operator characteristics analysis with area under the curve (AUC) and 95% confidence intervals (CI) were performed on the developmental data set (internal validation) as well as on an additional validation data set from another hospital (external validation).

Results

Five-hundred and forty-eight patients managed with an OA. Two variables remained in the multivariable prediction model for EAF. The AUC for EAF on internal validation were 0.74 (95% CI: 0.58-0.86) and 0.79 (95% CI: 0.67-0.92) on external validation.

Conclusions

A multivariable prediction model for EAF was externally validated and an easy-to-use probability nomogram was constructed using the two predictor variables.

Level of evidence

III; prognostic.

SUBMITTER: Cristaudo AT 

PROVIDER: S-EPMC9303347 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Development and validation of a multivariable prediction model in open abdomen patients for entero-atmospheric fistula.

Cristaudo Adam T AT   Hitos Kerry K   Gunnarsson Ronny R   Decosta Alan A  

ANZ journal of surgery 20220204 5


<h4>Background</h4>Laparostomy or Open Abdomen (OA) has matured into an effective strategy in the management of abdominal catastrophe. Single prognostic factors have been identified in a previous systematic review regarding entero-atmospheric fistula (EAF). Unfortunately, no prognostic multivariable model for EAF exist. The aim was to develop and validate a multivariable prediction model from a retrospective cohort study involving three hospital's databases.<h4>Methods</h4>Fifty-seven variables  ...[more]

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