Predicting postoperative mortality after colorectal surgery: a novel clinical model
| Autor: | Francesc Vallribera, B.L. van Leeuwen, Harald J. Hoekstra, Eloy Espin, G. H. de Bock, Alexander Engel, F. J. van der Sluis |
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| Přispěvatelé: | Damage and Repair in Cancer Development and Cancer Treatment (DARE), Life Course Epidemiology (LCE), Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Rok vydání: | 2013 |
| Předmět: |
Male
Risk medicine.medical_specialty FAST-TRACK SURGERY Population colorectal cancer MAJOR SURGERY Clinical prediction rule Logistic regression Risk Assessment clinical prediction rule CR-POSSUM Internal medicine P-POSSUM medicine Odds Ratio Humans CURATIVE RESECTION Hospital Mortality Postoperative Period education Emergency Treatment Aged Neoplasm Staging Netherlands Retrospective Studies Aged 80 and over Heart Failure education.field_of_study Receiver operating characteristic business.industry Gastroenterology Age Factors OPERATIVE MORTALITY Retrospective cohort study Odds ratio PHYSICAL STATUS Middle Aged CANCER SURGERY Confidence interval Colorectal surgery HOSPITAL STAY Surgery Spain Female business Respiratory Insufficiency POSSUM SCORING SYSTEM Colorectal Surgery |
| Zdroj: | Colorectal Disease, 16(8), 631-639. Wiley |
| ISSN: | 1463-1318 1462-8910 |
| Popis: | Aim The aim of this study was to develop and externally validate a clinically, practical and discriminative prediction model designed to estimate in-hospital mortality of patients undergoing colorectal surgery.Method All consecutive patients who underwent elective or emergency colorectal surgery from 1990 to 2005, at the Zaandam Medical Centre, The Netherlands, were included in this study. Multivariate logistic regression analysis was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) linking the explanatory variables to the outcome variable in-hospital mortality, and a simplified Identification of Risk in Colorectal Surgery (IRCS) score was constructed. The model was validated in a population of patients who underwent colorectal surgery from 2005 to 2011 in Barcelona, Spain. Predictive performance was estimated by calculating the area under the receiver operating characteristic curve.Results The strongest predictors of in-hospital mortality were emergency surgery (OR = 6.7, 95% CI 4.7-9.5), tumour stage (OR = 3.2, 95% CI 2.8-4.6), age (OR = 13.1, 95% CI 6.6-26.0), pulmonary failure (OR = 4.9, 95% CI 3.3-7.1) and cardiac failure (OR = 3.7, 95% CI 2.6-5.3). These parameters were included in the prediction model and simplified scoring system. The IRCS model predicted in-hospital mortality and demonstrated a predictive performance of 0.83 (95% CI 0.79-0.87) in the validation population. In this population the predictive performance of the CR-POSSUM score was 0.76 (95% CI 0.71-0.81).Conclusions The results of this study have shown that the IRCS score is a good predictor of in-hospital mortality after colorectal surgery despite the relatively low number of model parameters. |
| Databáze: | OpenAIRE |
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