Comparison of score-based prediction of 90-day mortality after liver resection
Autor: | Arianeb Mehrabi, Katrin Hoffmann, Ulf Hinz, Tanja Knoblich, Michael R. Schön, Markus W. Büchler, Christos Stravodimos |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty lcsh:Surgery 030230 surgery Standard score Logistic regression Risk Assessment Severity of Illness Index Resection 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Hepatectomy Humans Postoperative Period Stage (cooking) Mortality Aged Framingham Risk Score Receiver operating characteristic Liver resection business.industry Mortality rate General Medicine lcsh:RD1-811 Middle Aged Surgery Liver ROC Curve 030220 oncology & carcinogenesis Prognostic score Female Risk assessment business Research Article |
Zdroj: | BMC Surgery, Vol 20, Iss 1, Pp 1-8 (2020) BMC Surgery |
ISSN: | 1471-2482 |
Popis: | Background Indications for liver surgery are expanding fast and complexity of procedures increases. Preoperative mortality risk assessment by scoring systems is debatable. A previously published externally validated Mortality Risk Score allowed easy applicable and precise prediction of postoperative mortality. Aim of the study was to compare the performance of the Mortality Risk Score with the standard scores MELD and P-POSSUM. Methods Data of 529 patients undergoing liver resection were analysed. Mortality Risk Score, the labMELD Score and the P-POSSUM Scores (PS, OS, P-POSSUM mortality %) were calculated. The ROC curves of the three scoring systems were computed and the areas under the curve (C-index) were calculated using logistic regression models. Comparisons between the ROC curves were performed using the corresponding Wald tests. Results Internal validation confirmed that the risk model was predictive for a 90-day mortality rate with a C-index of 0.8421. The labMELD Score had a C-index of 0.7352 and the P-POSSUM system 0.6795 (PS 0.6953, OS 0.5413). The 90-day mortality rate increased with increasing labMELD values (p Conclusions By accurately predicting the risk of postoperative mortality after liver surgery the Mortality Risk Score should be useful at the selection stage. Prediction can be adjusted by use of the well-established labMELD Score. In contrast, the performance of standard P-POSSUM Scores is limited. |
Databáze: | OpenAIRE |
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