Comparison of a Risk Calculator With Frailty Indices in Patients Undergoing Lung Cancer Resection.

Autor: Vitello DJ; Northwestern Quality Improvement, Research, & Education in Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.; Surgery Service, Jesse Brown VA Medical Center, Chicago, Illinois, USA., Logan CD; Northwestern Quality Improvement, Research, & Education in Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.; Surgery Service, Jesse Brown VA Medical Center, Chicago, Illinois, USA.; Department of Surgery, Canning Thoracic Institute, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA., Zaza NN; Northwestern Quality Improvement, Research, & Education in Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.; Surgery Service, Jesse Brown VA Medical Center, Chicago, Illinois, USA., Bates KR; Northwestern Quality Improvement, Research, & Education in Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA., Jacobs R; Northwestern Quality Improvement, Research, & Education in Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.; Surgery Service, Jesse Brown VA Medical Center, Chicago, Illinois, USA.; Department of Surgery, Canning Thoracic Institute, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA., Feinglass J; Northwestern Quality Improvement, Research, & Education in Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA., Merkow RP; Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA., Bentrem DJ; Northwestern Quality Improvement, Research, & Education in Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.; Surgery Service, Jesse Brown VA Medical Center, Chicago, Illinois, USA.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2024 Oct 10. Date of Electronic Publication: 2024 Oct 10.
DOI: 10.1002/jso.27861
Abstrakt: Introduction: While frailty has gained attention for its utility in risk stratification, no studies have directly compared them to existing risk calculators. The objective of this study was to compare the risk stratification of the American College of Surgeons Surgical Risk Calculator (ACS-SRC), the Revised Risk Analysis Index (RAI-rev), and the Modified Frailty Index (5-mFI). The primary outcomes were 30-day postoperative morbidity, 30-day postoperative mortality, unplanned readmission, unplanned reoperation, and discharge disposition other than home.
Methods: Patients undergoing anatomic lung resection for primary, nonsmall cell lung cancer were identified within the ACS National Quality Improvement Program (ACS NSQIP) database. Tools were compared for discrimination in the primary outcomes.
Results: 9663 patients undergoing anatomic lung resection for cancer between 2012 and 2014 were included. The cohort was 53.1% female. Median age at diagnosis was 67 (IQR 59-74) years. Perioperative morbidity and mortality rates were 10.9% (n = 1048) and 1.6% (n = 158). Rates of 30-day postoperative unplanned readmission and reoperation were 7.5% (n = 725) and 4.8% (n = 468). The ACS-SRC had the highest discrimination for all measured outcomes, as measured by the area under the receiver operating curve (AUC) and corresponding confidence interval (95% CI). This included perioperative mortality (AUC 0.74, 95% CI 0.71-0.78), compared to RAI-rev (AUC 0.66, 95% CI 0.62-0.69) and 5-mFI (AUC 0.61, 95% CI 0.57-0.65; p < 0.001). The RAI-rev and 5-mFI had similar discrimination for all measured outcomes.
Conclusion: ACS-SRC was the perioperative risk stratification tool with the highest predictive discrimination for adverse, 30-day, postoperative events for patients with cancer treated with anatomic lung resection.
(© 2024 The Author(s). Journal of Surgical Oncology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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