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  3. Severity of oEsophageal Anastomotic Leak in patients after oesophagectomy: the SEAL score

Severity of oEsophageal Anastomotic Leak in patients after oesophagectomy: the SEAL score

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Ubels S.
  • Verstegen M.H.P.
  • Klarenbeek B.R.
  • Bouwense S.
  • van Berge Henegouwen M.I.
  • Daams F.
  • van Det M.J.
  • Griffiths E.A.
  • Haveman J.W.
  • Heisterkamp J.
  • Nieuwenhuijzen G.
  • Polat F.
  • Schouten J.
  • Siersema P.D.
  • Singh P.
  • Wijnhoven B.
  • Hannink G.
  • van Workum F.
  • Rosman C.
  • Matthée E.
  • Slootmans C.A.M.
  • Ultee G.
  • Gisbertz S.S.
  • Eshuis W.J.
  • Kalff M.C.
  • Feenstra M.L.
  • van der Peet D.L.
  • Stam W.T.
  • Van Etten B.
  • Poelmann F.
  • Vuurberg N.
  • van den Berg J.W.
  • Martijnse I.S.
  • Matthijsen R.M.
  • Luyer M.
  • Curvers W.
  • Nieuwenhuijzen T.
  • Taselaar A.E.
  • Kouwenhoven E.A.
  • Lubbers M.
  • Sosef M.
  • Lecot F.
  • Geraedts T.C.M.
  • van Esser S.
  • Dekker J.W.T.
  • van den Wildenberg F.
  • Kelder W.
  • Baas P.C.
  • de Haas J.W.A.
  • Hartgrink H.H.
  • Bahadoer R.R.
  • van Sandick J.W.
  • Hartemink K.J.
  • Veenhof X.
  • Stockmann H.
  • Gorgec B.
  • Weeder P.
  • Wiezer M.J.
  • Genders C.M.S.
  • Belt E.
  • Blomberg B.
  • van Duijvendijk P.
  • Claassen L.
  • Reetz D.
  • Steenvoorde P.
  • Mastboom W.
  • Ganseij H.J.K.
  • van Dalsen A.D.
  • Joldersma A.
  • Zwakman M.
  • Groenendijk R.P.R.
  • Montazeri M.
  • Mercer S.
  • Knight B.
  • van Boxel G.
  • McGregor R.J.
  • Skipworth R.J.E.
  • Frattini C.
  • Bradley A.
  • Nilsson M.
  • Hayami M.
  • Huang B.
  • Bundred J.
  • Evans R.
  • Grimminger P.P.
  • van Der Sluis P.C.
  • Eren U.
  • Saunders J.
  • Theophilidou E.
  • Khanzada Z.
  • Elliott J.A.
  • Ponten J.E.H.
  • King S.
  • Reynolds J.V.
  • Sgromo B.
  • Akbari K.
  • Shalaby S.
  • Gutschow C.A.
  • Schmidt H.
  • Vetter D.
  • Moorthy K.
  • Ibrahim M.A.H.
  • Christodoulidis G.
  • Räsänen J.V.
  • Kauppi J.
  • Söderström H.
  • Koshy R.
  • Manatakis D.K.
  • Korkolis D.P.
  • Balalis D.
  • Rompu A.
  • Alkhaffaf B.
  • Alasmar M.
  • Arebi M.
  • Piessen G.
  • Nuytens F.
  • Degisors S.
  • Ahmed A.
  • Boddy A.
  • Gandhi S.
  • Fashina O.
  • Van Daele E.
  • Pattyn P.
  • Robb W.B.
  • Arumugasamy M.
  • Al Azzawi M.
  • Whooley J.
  • Colak E.
  • Aybar E.
  • Sari A.C.
  • Uyanik M.S.
  • Ciftci A.B.
  • Sayyed R.
  • Ayub B.
  • Murtaza G.
  • Saeed A.
  • Ramesh P.
  • Charalabopoulos A.
  • Liakakos T.
  • Schizas D.
  • Baili E.
  • Kapelouzou A.
  • Valmasoni M.
  • Pierobon E.S.
  • Capovilla G.
  • Merigliano S.
  • Constantinoiu S.
  • Birla R.
  • Achim F.
  • Rosianu C.G.
  • Hoara P.
  • Castro R.G.
  • Salcedo A.F.
  • Negoi I.
  • Negoita V.M.
  • Ciubotaru C.
  • Stoica B.
  • Hostiuc S.
  • Colucci N.
  • Mönig S.P.
  • Wassmer C.-H.
  • Meyer J.
  • Takeda F.R.
  • Sallum R.A.A.
  • Ribeiro U.
  • Cecconello I.
  • Toledo E.
  • Trugeda M.S.
  • Fernández M.J.
  • Gil C.
  • Castanedo S.
  • Isik A.
  • Kurnaz E.
  • Videira J.F.
  • Peyroteo M.
  • Canotilho R.
  • Weindelmayer J.
  • Giacopuzzi S.
  • De Pasqual C.A.
  • Vaque J.
  • Pérez C.
  • Phillips A.W.
  • Chmelo J.
  • Brown J.
  • Han L.E.
  • Gossage J.A.
  • Davies A.R.
  • Baker C.R.
  • Kelly M.
  • Saad M.
  • Bernardi D.
  • Bonavina L.
  • Asti E.
  • Riva C.
  • Scaramuzzo R.
  • Ahmed H.A.
  • Elhadi A.
  • Elnagar F.A.
  • Msherghi A.A.A.
  • Wills V.
  • Campbell C.
  • Cerdeira M.P.
  • Whiting S.
  • Merrett N.
  • Das A.
  • Apostolou C.
  • Lorenzo A.
  • Sousa F.
  • Barbosa J.A.
  • Devezas V.
  • Barbosa E.
  • Fernandes C.
  • Smith G.
  • Li E.Y.
  • Bhimani N.
  • Chan P.
  • Kotecha K.
  • Hii M.W.
  • Ward S.M.
  • Johnson M.
  • Read M.
  • Chong L.
  • Hollands M.J.
  • Allaway M.
  • Richardson A.
  • Johnston E.
  • Chen A.Z.L.
  • Kanhere H.
  • Prasad S.
  • McQuillan P.
  • Surman T.
  • Trochsler M.I.
  • Schofield W.A.
  • Ahmed S.K.
  • Reid J.L.
  • Harris M.C.
  • Gananadha S.
  • Farrant J.
  • Rodrigues N.
  • Fergusson J.
  • Hindmarsh A.
  • Afzal Z.
  • Safranek P.
  • Sujendran V.
  • Rooney S.
  • Carlos Loureiro
  • Saioa Leturio Fernandez
  • del Val I.D.
  • Jaunoo S.
  • Kennedy L.
  • Hussain A.
  • Theodorou D.
  • Triantafyllou T.
  • Theodoropoulos C.
  • Palyvou T.
  • Elhadi M.
  • Ben Taher F.A.
  • Ekheel M.

Grupos

Abstract

Background: Anastomotic leak (AL) is a common but severe complication after oesophagectomy. It is unknown how to determine the severity of AL objectively at diagnosis. Determining leak severity may guide treatment decisions and improve future research. This study aimed to identify leak-related prognostic factors for mortality, and to develop a Severity of oEsophageal Anastomotic Leak (SEAL) score. Methods: This international, retrospective cohort study in 71 centres worldwide included patients with AL after oesophagectomy between 2011 and 2019. The primary endpoint was 90-day mortality. Leak-related prognostic factors were identified after adjusting for confounders and were included in multivariable logistic regression to develop the SEAL score. Four classes of leak severity (mild, moderate, severe, and critical) were defined based on the risk of 90-day mortality, and the score was validated internally. Results: Some 1509 patients with AL were included and the 90-day mortality rate was 11.7 per cent. Twelve leak-related prognostic factors were included in the SEAL score. The score showed good calibration and discrimination (c-index 0.77, 95 per cent c.i. 0.73 to 0.81). Higher classes of leak severity graded by the SEAL score were associated with a significant increase in duration of ICU stay, healing time, Comprehensive Complication Index score, and Esophagectomy Complications Consensus Group classification. Conclusion: The SEAL score grades leak severity into four classes by combining 12 leak-related predictors and can be used to the assess severity of AL after oesophagectomy. © 2022 The Author(s). Published by Oxford University Press on behalf of BJS Society Ltd.

Datos de la publicación

ISSN/ISSNe:
0007-1323, 1365-2168

BJS-British Journal of Surgery  OXFORD UNIV PRESS

Tipo:
Article
Páginas:
864-871
PubMed:
35759409
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
2,479 SCImago ℠
Cuartil:
Q1 SCImago ℠

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Keywords

  • Anastomosis, Surgical; Anastomotic Leak; Esophageal Neoplasms; Esophagectomy; Humans; Logistic Models; Retrospective Studies; C reactive protein; accuracy; aged; anastomosis leakage; Article; cohort analysis; comorbidity; decision making; disease severity; endoscopy; esophagectomy; female; human; ischemia; kidney failure; leukocyte count; lower esophagus sphincter; male; mortality; mortality rate; outcome assessment; prognosis; quality control; respiratory failure; retrospective study; adverse event; anastomosis; anastomosis leakage; complication; esophagus tumor; statistical model

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