A Novel, Dynamic Statistical Model for Predicting Patient Satisfaction with Fundoplication Based on Pre-Operative...

Area of Science:

• Gastroenterology
• Surgical Outcomes Research

Background:

• Fundoplication effectively manages gastro-oesophageal reflux disease (GORD).
• A subset of patients report dissatisfaction post-fundoplication, with difficulty in pre-operative identification.
• Predicting post-operative dissatisfaction is crucial for patient selection and management.

Purpose of the Study:

• To develop and validate a novel score predicting pre-operative risk of dissatisfaction (PROD) after fundoplication.
• To assess the prognostic utility of the PROD score compared to routine investigations and existing guidelines.

Main Methods:

• Standardized questionnaires assessed pre-operative symptoms and post-operative satisfaction in 225 patients.
• A novel pre-operative risk of dissatisfaction (PROD) score was calculated.
• Receiver operating characteristic (ROC) analysis evaluated the prognostic utility of the PROD score and SAGES guidelines (n=166).

Main Results:

• The PROD score showed significant association with post-operative satisfaction (p < 0.001) and prognostic utility (AUC = 0.67-0.79).
• Routine investigations did not correlate with post-operative satisfaction.
• The PROD score demonstrated superior prognostic utility compared to the SAGES guideline (p < 0.001).

Conclusions:

• The PROD score is a novel, user-friendly tool for predicting individual patient satisfaction with fundoplication.
• This score can aid in identifying patients at risk of dissatisfaction, potentially improving surgical decision-making.