{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:07:15Z","timestamp":1791522435020,"version":"4.3.4"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010711","name":"Cancer Foundation Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010711","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Paulo Foundation"},{"name":"the Finnish Medical Foundation"},{"name":"Helsinki University Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Every fifth patient undergoing left pancreatectomy develops a postoperative pancreatic fistula (POPF). Accurate POPF risk prediction could help. Two independent preoperative prediction models have been developed and externally validated: DISPAIR and D-FRS. The aim of this study was to validate, compare, and possibly update the models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients from nine high-volume pancreatic surgery centres (8 in Europe and 1 in North America) were included in this retrospective cohort study. Inclusion criteria were age over 18 years and open or minimally invasive left pancreatectomy since 2010. Model performance was assessed with discrimination (receiver operating characteristic (ROC) curves) and calibration (calibration plots). The updated model was developed with logistic regression and internally-externally validated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 2284 patients included, 497 (21.8%) developed POPF. Both DISPAIR (area under the ROC curve (AUC) 0.62) and D-FRS (AUC 0.62) performed suboptimally, both in the pooled validation cohort combining every centre\u2019s data and centre-wise. An updated model, named DISPAIR-FRS, was constructed by combining the most stable predictors from the existing models and incorporating other readily available patient demographics, such as age, sex, transection site, pancreatic thickness at the transection site, and main pancreatic duct diameter at the transection site. Internal-external validation demonstrated an AUC of 0.72, a calibration slope of 0.93, and an intercept of \u22120.02 for the updated model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The combined updated model of DISPAIR and D-FRS named DISPAIR-FRS demonstrated better performance and can be accessed at www.tinyurl.com\/the-dispair-frs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znae313","type":"journal-article","created":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T04:39:19Z","timestamp":1742704759000},"source":"Crossref","is-referenced-by-count":7,"title":["International multicentre validation of the left pancreatectomy pancreatic fistula prediction models and development and validation of the combined DISPAIR-FRS prediction model"],"prefix":"10.1093","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2096-6131","authenticated-orcid":false,"given":"Akseli","family":"Bonsdorff","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trond","family":"Kjeseth","sequence":"additional","affiliation":[{"name":"Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Oslo, Norway"},{"name":"Department of Clinical Medicine, University of Bergen , Bergen ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6994-0637","authenticated-orcid":false,"given":"Jakob","family":"Kirkeg\u00e5rd","sequence":"additional","affiliation":[{"name":"Department of Surgery, HPB Section and Institute for Clinical Medicine, Aarhus University Hospital , Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6011-7663","authenticated-orcid":false,"given":"Charles","family":"de Ponthaud","sequence":"additional","affiliation":[{"name":"Department of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, AP-HP Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Sorbonne Universit\u00e9 Paris , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poya","family":"Ghorbani","sequence":"additional","affiliation":[{"name":"Division of Surgery and Oncology, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2757-7489","authenticated-orcid":false,"given":"Johanna","family":"Wennerblom","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sahlgrenska University Hospital , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9743-3149","authenticated-orcid":false,"given":"Caroline","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sk\u00e5ne University Hospital at Lund, Lund University , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra W","family":"Acher","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto and Sunnybrook Health Sciences Centre , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Thillai","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Pancreatic Unit & Edinburgh Transplant Unit, University of Edinburgh, Royal Infirmary , Edinburgh ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Tarvainen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Helsinki University Hospital and University of Helsinki , Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilkka","family":"Helanter\u00e4","sequence":"additional","affiliation":[{"name":"Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1324-5894","authenticated-orcid":false,"given":"Aki","family":"Uutela","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Pancreatic Unit & Edinburgh Transplant Unit, University of Edinburgh, Royal Infirmary , Edinburgh ,","place":["UK"]},{"name":"Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jukka","family":"Sir\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Helsinki University Hospital and University of Helsinki , Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arto","family":"Kokkola","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Helsinki University Hospital and University of Helsinki , Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4815-7694","authenticated-orcid":false,"given":"Mushegh","family":"Sahakyan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vestre Viken Hospital Trust, Ringerike Hospital , H\u00f8nefoss ,","place":["Norway"]},{"name":"The Intervention Centre, Oslo University Hospital, Rikshospitalet , Oslo ,","place":["Norway"]},{"name":"Department of Surgery N1, Yerevan State Medical University , Yerevan ,","place":["Armenia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dyre","family":"Kleive","sequence":"additional","affiliation":[{"name":"Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital , Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Hagen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vestfold Hospital Trust , T\u00f8nsberg ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lund","sequence":"additional","affiliation":[{"name":"Department of Surgery, HPB Section and Institute for Clinical Medicine, Aarhus University Hospital , Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette F","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Surgery, HPB Section and Institute for Clinical Medicine, Aarhus University Hospital , Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Vaillant","sequence":"additional","affiliation":[{"name":"Division of Surgery and Oncology, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Karolinska University Hospital , Stockholm 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