Development of a preoperative risk score on admission in surgical intermediate care unit in gastrointestinal cancer surgery.
Oncological digestive surgeries
Postoperative complications
Prediction of mortality
Preoperative risk scoring
Journal
Perioperative medicine (London, England)
ISSN: 2047-0525
Titre abrégé: Perioper Med (Lond)
Pays: England
ID NLM: 101609072
Informations de publication
Date de publication:
2020
2020
Historique:
received:
16
10
2019
accepted:
10
06
2020
entrez:
11
8
2020
pubmed:
11
8
2020
medline:
11
8
2020
Statut:
epublish
Résumé
Gastrointestinal cancer surgery continues to be a significant cause of postoperative complications and mortality in high-risk patients. It is crucial to identify these patients. Our study aimed to evaluate the accuracy of specific perioperative risk assessment tools to predict postoperative complications, identifying the most informative variables and combining them to test their prediction ability as a new score. A prospective cohort study of digestive cancer surgical patients admitted to the surgical intermediate care unit of the Portuguese Oncology Institute of Porto, Portugal was conducted during the period January 2016 to April 2018. Demographic and medical information including sex, age, date from hospital admission, diagnosis, emergency or elective admission, and type of surgery, were collected. We analyzed and compared a set of measurements of surgical risk using the risk assessment instruments P-POSSUM Scoring, ACS NSQIP Surgical Risk Calculator, and ARISCAT Risk Score according to the outcomes classified by the Clavien-Dindo score. According to each risk score system, we studied the expected and observed post-operative complications. We performed a multivariable regression model retaining only the significant variables of these tools (age, gender, physiological P-Possum, and ACS NSQIP serious complication rate) and created a new score ( We studied 341 patients. Our results showed that the predictive accuracy and agreement of P-POSSUM Scoring, ACS NSQIP Surgical Risk Calculator, and ARISCAT Risk Score were limited. The The feasibility and usefulness of the
Sections du résumé
BACKGROUND
BACKGROUND
Gastrointestinal cancer surgery continues to be a significant cause of postoperative complications and mortality in high-risk patients. It is crucial to identify these patients. Our study aimed to evaluate the accuracy of specific perioperative risk assessment tools to predict postoperative complications, identifying the most informative variables and combining them to test their prediction ability as a new score.
METHODS
METHODS
A prospective cohort study of digestive cancer surgical patients admitted to the surgical intermediate care unit of the Portuguese Oncology Institute of Porto, Portugal was conducted during the period January 2016 to April 2018. Demographic and medical information including sex, age, date from hospital admission, diagnosis, emergency or elective admission, and type of surgery, were collected. We analyzed and compared a set of measurements of surgical risk using the risk assessment instruments P-POSSUM Scoring, ACS NSQIP Surgical Risk Calculator, and ARISCAT Risk Score according to the outcomes classified by the Clavien-Dindo score. According to each risk score system, we studied the expected and observed post-operative complications. We performed a multivariable regression model retaining only the significant variables of these tools (age, gender, physiological P-Possum, and ACS NSQIP serious complication rate) and created a new score (
RESULTS
RESULTS
We studied 341 patients. Our results showed that the predictive accuracy and agreement of P-POSSUM Scoring, ACS NSQIP Surgical Risk Calculator, and ARISCAT Risk Score were limited. The
CONCLUSIONS
CONCLUSIONS
The feasibility and usefulness of the
Identifiants
pubmed: 32774846
doi: 10.1186/s13741-020-00151-7
pii: 151
pmc: PMC7409477
doi:
Types de publication
Journal Article
Langues
eng
Pagination
23Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Competing interestsThe authors declare that they have no competing interests.
Références
Eur J Cancer Care (Engl). 2009 Mar;18(2):202-8
pubmed: 19267738
Rev Col Bras Cir. 2018;45(1):e1347
pubmed: 29451643
Dig Surg. 2016;33(1):74-81
pubmed: 26632818
Int J Surg. 2015 Jun;18:184-90
pubmed: 25937154
Int J Cancer. 2019 Apr 15;144(8):1941-1953
pubmed: 30350310
Surg Endosc. 2012 May;26(5):1287-95
pubmed: 22044981
JAMA Oncol. 2017 Apr 1;3(4):524-548
pubmed: 27918777
Anesthesiology. 2014 Aug;121(2):219-31
pubmed: 24901240
Ann Surg. 2019 Apr;269(4):652-662
pubmed: 29489489
Medicine (Baltimore). 2015 May;94(17):e812
pubmed: 25929938
Ann Surg Oncol. 2008 Oct;15(10):2692-700
pubmed: 18663532
JAMA Surg. 2017 Feb 1;152(2):157-166
pubmed: 27829093
Curr Anesthesiol Rep. 2017;7(4):340-349
pubmed: 29200973
J Am Coll Surg. 2017 Nov;225(5):601-611
pubmed: 28826803
Br J Anaesth. 2017 Mar 1;118(3):317-334
pubmed: 28186222
Ann Surg. 2002 Jan;235(1):105-12
pubmed: 11753049
BMC Anesthesiol. 2014 Nov 18;14:104
pubmed: 25469106
Arch Surg. 1998 Nov;133(11):1200-5
pubmed: 9820351
World J Surg. 2002 Apr;26(4):499-502
pubmed: 11910487
Br J Surg. 1996 Jun;83(6):812-5
pubmed: 8696749
Surg Today. 1999;29(3):219-25
pubmed: 10192731
Br J Surg. 1991 Mar;78(3):355-60
pubmed: 2021856
Lancet. 2008 Jul 12;372(9633):139-44
pubmed: 18582931
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
J Gastrointest Surg. 2019 Jun;23(6):1180-1187
pubmed: 30465189
Anaesthesia. 2008 Jul;63(7):695-700
pubmed: 18489613
Int J Surg. 2017 Mar;39:156-162
pubmed: 28161527
Ann Surg Oncol. 2014 Aug;21(8):2601-7
pubmed: 24664626
Gastric Cancer. 2014;17(3):548-55
pubmed: 23996129