Performance validation of the ALPPS risk model. Issue 6 (June 2019)

• Record Type: Journal Article
• Authors: Linecker, Michael; Kuemmerli, Christoph; Kambakamba, Patryk; Schlegel, Andrea; Muiesan, Paolo; Capobianco, Ivan; Nadalin, Silvio; Torres, Orlando J.; Mehrabi, Arianeb; Stavrou, Gregor A.; Oldhafer, Karl J.; Lurje, Georg; Balci, Deniz; Lang, Hauke; Robles-Campos, Ricardo; Hernandez-Alejandro, Roberto; Malago, Massimo; De Santibanes, Eduardo; Clavien, Pierre-Alain; Petrowsky, Henrik
• Is Part Of: HPB. Volume 21:Issue 6(2019)
• Page Start: 711
• Page End: 721
• Publication Date: 2019-06
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2018.10.003
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Based on the International ALPPS registry, we have recently proposed two easily applicable risk models (pre-stage1 and 2) for predicting 90-day mortality in ALPPS but a validation of both models has not been performed yet. Methods: The validation cohort (VC) was composed of subsequent cases of the ALPPS registry and cases of centers outside the ALPPS registry. Results: The VC was composed of a total of 258 patients including 70 patients outside the ALPPS registry with 32 cases of early mortalities (12%). Development cohort (DC) and VC were comparable in terms of patient and surgery characteristics. The VC validated both models with an acceptable prediction for the pre-stage 1 ( c -statistic 0.64, P = 0.009 vs . 0.77, P < 0.001) and a good prediction for the pre-stage 2 model ( c -statistic 0.77, P < 0.001 vs . 0.85, P < 0.001) as compared to the DC. Overall model performance measured by Brier score was comparable between VC and DC for the pre-stage 1 (0.089 vs . 0.081) and pre-stage 2 model (0.079 vs . 0087). Conclusion: The ALPPS risk score is a fully validated model to estimate the individual risk of patients undergoing ALPPS and to assist clinical decision making to avoid procedure-related early mortality after ALPPS.