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Catalogo dei prodotti della ricerca
Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise descrip-tion of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.
Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.
Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respec-tively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty.
Correction to: Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy / Griffiths, E.A., Hodson, J., Vohra, R.S., Marriott, P., Katbeh, T., Zino, S., Nassar, A.H.M., Kirkham, A.J., Pasquali, S., Johnstone, M., Spreadborough, P., Alderson, D., Fenwick, S., Elmasry, M., Nunes, Q.M., Kennedy, D., Khan, R.B., Khan, M.A.S., Magee, C.J., Jones, S.M., et al.. - In: SURGICAL ENDOSCOPY. - ISSN 0930-2794. - 33:1(2019), pp. 122-125. [10.1007/s00464-018-6377-8]
Correction to: Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy
Griffiths E. A.;Hodson J.;Vohra R. S.;Marriott P.;Katbeh T.;Zino S.;Nassar A. H. M.;Kirkham A. J.;Pasquali S.;Johnstone M.;Spreadborough P.;Alderson D.;Fenwick S.;Elmasry M.;Nunes Q. M.;Kennedy D.;Khan R. B.;Khan M. A. S.;Magee C. J.;Jones S. M.;Mason D.;Parappally C. P.;Mathur P.;Saunders M.;Jamel S.;Haque S. U.;Zafar S.;Shiwani M. H.;Samuel N.;Dar F.;Jackson A.;Lovett B.;Dindyal S.;Winter H.;Fletcher T.;Rahman S.;Wheatley K.;Nieto T.;Ayaani S.;Youssef H.;Nijjar R. S.;Watkin H.;Naumann D.;Emesih S.;Sarmah P. B.;Lee K.;Joji N.;Lambert J.;Heath J.;Teasdale R. L.;Weerasinghe C.;Needham P. J.;Welbourn H.;Forster L.;Finch D.;Blazeby J. M.;Robb W.;McNair A. G. K.;Hrycaiczuk A.;Charalabopoulos A.;Kadirkamanathan S.;Tang C. -B.;Jayanthi N. V. G.;Noor N.;Dobbins B.;Cockbain A. J.;Nilsen-Nunn A.;de Siqueira J.;Pellen M.;Cowley J. B.;Ho W. -M.;Miu V.;White T. J.;Hodgkins K. A.;Kinghorn A.;Tutton M. G.;Al-Abed Y. A.;Menzies D.;Ahmad A.;Reed J.;Khan S.;Monk D.;Vitone L. J.;Murtaza G.;Joel A.;Brennan S.;Shier D.;Zhang C.;Yoganathan T.;Robinson S. J.;McCallum I. J. D.;Jones M. J.;Elsayed M.;Tuck L.;Wayman J.;Carney K.;Aroori S.;Hosie K. B.;Kimble A.;Bunting D. M.;Hosie K. B.;Fawole A. S.;Basheer M.;Dave R. V.;Sarveswaran J.;Jones E.;Kendal C.;Tilston M. P.;Gough M.;Wallace T.;Singh S.;Mockford J. D. K. A.;Issa E.;Shah N.;Chauhan N.;Wilson T. R.;Forouzanfar A.;Wild J. R. L.;Nofal E.;Bunnell C.;Madbak K.;Rao S. T. V.;Devoto L.;Siddiqi N.;Khawaja Z.;Hewes J. C.;Gould L.;Chambers A.;Rodriguez D. U.;Sen G.;Robinson S.;Carney K.;Bartlett F.;Rae D. M.;Stevenson T. E. J.;Sarvananthan K.;Dwerryhouse S. J.;Higgs S. M.;Old O. J.;Hardy T. J.;Hornby R. S. S. T.;Keogh K.;Frank L.;Al-Akash M.;Upchurch E. A.;Frame R. J.;Hughes M.;Jelley C.;Weaver S.;Roy S.;Sillo T. O.;Galanopoulos G.;Cuming T.;Cunha P.;Tayeh S.;Kaptanis S.;Heshaishi M.;Eisawi A.;Abayomi M.;Ngu W. S.;Fleming K.;Bajwa D. S.;Chitre V.;Aryal K.;Ferris P.;Silva M.;Mohamed S. L. S.;Khawaja A.;Hussain A.;Ghazanfar M. A.;Bellini M. I.;Ebdewi H.;Elshaer M.;Gravante G.;Drake B.;Ogedegbe A.;Mukherjee D.;Arhi C.;Iqbal L. G. N.;Watson N. F.;Aggarwal S. K.;Orchard P.;Villatoro E.;Willson P. D.;Mok K. W. J.;Woodman T.;Deguara J.;Garcea G.;Babu B. I.;Dennison A. R.;Malde D.;Lloyd D.;Satheesan S.;Al-Taan O.;Boddy A.;Slavin J. P.;Jones R. P.;Ballance L.;Gerakopoulos S.;Jambulingam P.;Mansour S.;Sakai N.;Acharya V.;Sadat M. M.;Karim L.;Larkin D.;Amin K.;Khan A.;Law J.;Jamdar S.;Smith S. R.;Sampat K.;O'shea K. M.;Manu M.;Asprou F. M.;Malik N. S.;Chang J.;Lewis M.;Roberts G. P.;Karavadra B.;Photi E.;Hewes J.;Gould L.;Chambers A.;Rodriguez D.;O'Reilly D. A.;Rate A. J.;Sekhar H.;Henderson L. T.;Starmer B. Z.;Coe P. O.;Tolofari S.;Barrie J.;Bashir G.;Sloane J.;Madanipour S.;Halkias C.;Trevatt A. E. J.;Borowski D. W.;Hornsby J.;Courtney M. J.;Virupaksha S.;Seymour K.;Robinson S.;Hawkins H.;Bawa S.;Gallagher P. V.;Reid A.;Wood P.;Finch J. G.;Guy Finch J.;Parmar J.;Stirland E.;Gardner-Thorpe J.;Al-Muhktar A.;Peterson M.;Majeed A.;Bajwa F. M.;Martin J.;Choy A.;Tsang A.;Pore N.;Andrew D. R.;Al-Khyatt W.;Bhandari C. T. S.;Chambers A.;Subramanium D.;Toh S. K. C.;Carter N. C.;Tate S.;Pearce B.;Wainwright D.;Mercer S. J.;Knight B.;Vijay V.;Alagaratnam S.;Sinha S.;Khan S.;El-Hasani S. S.;Hussain A. A.;Bhattacharya V.;Kansal N.;Fasih T.;Jackson C.;Siddiqui M. N.;Chishti I. A.;Fordham I. J.;Siddiqui Z.;Bausbacher H.;Geogloma I.;Gurung K.;Tsavellas G.;Basynat P.;Shrestha A. K.;Basu S.;Harilingam A. C. M.;Rabie M.;Akhtar M.;Kumar P.;Jafferbhoy S. F.;Hussain N.;Raza S.;Haque M.;Alam I.;Aseem R.;Patel S.;Asad M.;Booth M. I.;Ball W. R.;Wood C. P. J.;Pinho-Gomes A. C.;Kausar A.;Obeidallah M. R.;Varghase J.;Lodhia J.;Bradley D.;Rengifo C.;Lindsay D.;Gopalswamy S.;Finlay I.;Wardle S.;Bullen N.;Iftikhar S. Y.;Awan A.;Ahmed J.;Leeder P.;Fusai G.;Bond-Smith G.;Psica A.;Puri Y.;Hou D.;Noble F.;Szentpali K.;Broadhurst J.;Date R.;Hossack M. R.;Goh Y. L.;Turner P.;Shetty V.;Riera M.;Macano C. A. W.;Sukha A.;Preston S. R.;Hoban J. R.;Puntis D. J.;Williams S. V.;Krysztopik R.;Kynaston J.;Batt J.;Doe M.;Goscimski A.;Jones G. H.;Smith S. R.;Hall C.;Carty N.;Ahmed J.;Panteleimonitis S.;Gunasekera R. T.;Sheel A. R. G.;Lennon H.;Hindley C.;Reddy M.;Kenny R.;Elkheir N.;McGlone E. R.;Rajaganeshan R.;Hancorn K.;Hargreaves A.;Prasad R.;Longbotham D. A.;Vijayanand D.;Wijetunga I.;Ziprin P.;Nicolay C. R.;Yeldham G.;Read E.;Gossage J. A.;Rolph R. C.;Ebied H.;Phull M.;Khan M. A.;Popplewell M.;Kyriakidis D.;Hussain A.;Henley N.;Packer J. R.;Derbyshire L.;Porter J.;Appleton S.;Farouk M.;Basra M.;Jennings N. A.;Ali S.;Kanakala V.;Ali H.;Lane R.;Dickson-Lowe R.;Zarsadias P.;Mirza D.;Puig S.;Amari K. A.;Vijayan D.;Sutcliffe R.;Marudanayagam R.;Hamady Z.;Prasad A. R.;Patel A.;Durkin D.;Kaur P.;Bowen L.;Byrne J. P.;Pearson K. L.;Delisle T. G.;Davies J.;Tomlinson M. A.;Johnpulle M. A.;Slawinski C.;Macdonald A.;Nicholson J.;Newton K.;Mbuvi J.;Farooq A.;Mothe B. S.;Zafrani Z.;Brett D.;Francombe J.;Barnes J.;Cheung M.;Al-Bahrani A. Z.;Preziosi G.;Urbonas T.;Alberts J.;Mallik M.;Patel K.;Segaran A.;Doulias T.;Sufi P. A.;Yao C.;Pollock S.;Manzelli A.;Wajed S.;Kourkulos M.;Pezzuto R.;Wadley M.;Hamilton E.;Jaunoo S.;Padwick R.;Sayegh M.;Newton R. C.;Hebbar M.;Farag S. F.;Spearman J.;Hamdan M. F.;D'Costa C.;Blane C.;Giles M.;Peter M. B.;Hirst N. A.;Hossain T.;El-Dhuwaib A. P. Y.;Morrison T. E. M.;Taylor G. W.;Thompson R. L. E.;McCune K.;Loughlin P.;Lawther R.;Byrnes C. K.;Simpson D. J.;Mawhinney A.;Warren C.;McKay D.;McIlmunn C.;Martin S.;MacArtney M.;Diamond T.;Davey P.;Jones C.;Clements J. M.;Digney R.;Chan W. M.;McCain S.;Gull S.;Janeczko A.;Dorrian E.;Harris A.;Dawson S.;Johnston D.;McAree B.;Ghareeb E.;Thomas G.;Connelly M.;McKenzie S.;Cieplucha K.;Spence G.;Campbell W.;Hooks G.;Bradley N.;Hill A. D. K.;Cassidy J. T.;Boland M.;Burke P.;Nally D. M.;Hill A. D. K.;Khogali E.;Shabo W.;Iskandar E.;McEntee G. P.;O'Neill M. A.;Peirce C.;Lyons E. M.;O'Sullivan A. W.;Thakkar R.;Carroll P.;Ivanovski I.;Balfe P.;Lee M.;Winter D. C.;Kelly M. E.;Hoti E.;Maguire D.;Karunakaran P.;Geoghegan J. G.;McDermott F.;Martin S. T.;Cross K. S.;Cooke F.;Zeeshan S.;Murphy J. O.;Mealy K.;Mohan H. M.;Nedujchelyn Y.;Ullah M. F.;Ahmed I.;Giovinazzo F.;Milburn J.;Prince S.;Brooke E.;Buchan J.;Khalil A. M.;Vaughan E. M.;Ramage M. I.;Aldridge R. C.;Gibson S.;Nicholson G. A.;Vass D. G.;Grant A. J.;Holroyd D. J.;Angharad Jones M.;Sutton C. M. L. R.;O'Dwyer P.;Nilsson F.;Weber B.;Williamson T. K.;Lalla K.;Bryant A.;Ross Carter C.;Forrest C. R.;Hunter D. I.;Nassar A. H.;Orizu M. N.;Knight K.;Qandeel H.;Suttie S.;Belding R.;McClarey A.;Boyd A. T.;Guthrie G. J. K.;Lim P. J.;Luhmann A.;Watson A. J. M.;Richards C. H.;Nicol L.;Madurska M.;Harrison E.;Boyce K. M.;Roebuck A.;Ferguson G.;Pati P.;Wilson M. S. J.;Dalgaty F.;Fothergill L.;Driscoll P. J.;Mozolowski K. L.;Banwell V.;Bennett S. P.;Rogers P. N.;Skelly B. L.;Rutherford C. L.;Mirza A. K.;Lazim T.;Lim H. C. C.;Duke D.;Ahmed T.;Beasley W. D.;Wilkinson M. D.;Maharaj G.;Malcolm C.;Brown T. H.;Al-Sarireh B.;Shingler G. M.;Mowbray N.;Radwan R.;Morcous P.;Wood S.;Kadhim A.;Stewart D. J.;Baker A. L.;Tanner N.;Shenoy H.;Hafiz S.;De Marchi J. A.;Singh-Ranger D.;Hisham E.;Ainley P.;John Terrace S. O. N.;Napetti S.;Hopwood B.;Rhys T.;Downing J.;Kanavati O.;Coats M.;Aleksandrov D.;Kallaway C.;Yahya S.;Weber B.;Templeton A.;Trotter M.;Lo C.;Dhillon A.;Heywood N.;Aawsaj Y.;Hamdan A.;Reece-Bolton O.;McGuigan A.;Shahin Y.;Aymon;Luther A. A.;Nicholson J. A.;Rajendran I.;Boal M.;Ritchie J.
2019
Abstract
Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise descrip-tion of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.
Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.
Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respec-tively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1603400
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
