Cristaudo, Adam T., Hitos, Kerry, Gunnarsson, Ronny, and Decosta, Alan (2022) Development and validation of a multivariable prediction model in open abdomen patients for entero-atmospheric fistula. ANZ Journal of Surgery, 92 (5). pp. 1079-1084.

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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.

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