ArticleAnnals of surgical oncology2019
Assessment of the Value of Comorbidity Indices for Risk Adjustment in Colorectal Surgery Patients.
Article in Annals of surgical oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictive Ability of Comorbidity Indices for Surgical Morbidity and Mortality: a Systematic Review and Meta-analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Pooled it
- Comorbidity Patterns in Patients Newly Diagnosed With Colorectal Cancer: Network-Based Study.JMIR public health and surveillance · 2023Observational
- Predicting the prognosis of lower rectal cancer using preoperative magnetic resonance imaging with artificial intelligence.Techniques in coloproctology · 2023Article
- Influence of type II diabetes mellitus on postoperative complications following colorectal cancer surgery.Experimental and therapeutic medicine · 2022Article
- Extended Lymphadenectomy for Proximal Transverse Colon Cancer: Is There a Place for Standardization?Medicina (Kaunas, Lithuania) · 2022Article
- Predictors of surgical outcomes of minimally invasive right colectomy: the MERCY study.International journal of colorectal disease · 2022Article
- Postoperative Complications of Free Flap Reconstruction in Moderate-Advanced Head and Neck Squamous Cell Carcinoma: A Prospective Cohort Study Based on Real-World Data.Frontiers in oncology · 2022Article
- Article
- Association of Medicaid Eligibility With Surgical Readmission Among Medicare Beneficiaries.JAMA network open · 2020Article
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Authors and funding
11 authors.
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Abstract
background and purposeComorbidity indices (CIs) are widely used in retrospective studies. We investigated the value of commonly used CIs in risk adjustment for postoperative complications after colorectal surgery.
methodsPatients undergoing colectomy without stoma for colonic neoplasia at a single institution from 2009 to 2014 were included. Four CIs were calculated or obtained for each patient, using administrative data: Charlson-Deyo (CCI-D), Charlson-Romano (CCI-R), Elixhauser Comorbidity Score, and American Society of Anesthesiologists classification. Outcomes of interest in the 90-day postoperative period were any surgical complication, surgical site infection (SSI), Clavien-Dindo (CD) grade 3 or higher complication, anastomotic leak or abscess, and nonroutine discharge. Base models were created for each outcome based on significant bivariate associations. Logistic regression models were constructed for each outcome using base models alone, and each index as an additional covariate. Models were also compared using the DeLong and Clarke-Pearson method for receiver operating characteristic (ROC) curves, with the CCI-D as the reference.
resultsOverall, 1813 patients were included. Postoperative complications were reported in 756 (42%) patients. Only 9% of patients had a CD grade 3 or higher complication, and 22.8% of patients developed an SSI. Multivariable modeling showed equivalent performance of the base model and the base model augmented by the CIs for all outcomes. The ROC curves for the four indices were also similar.
conclusionsThe inclusion of CIs added little to the base models, and all CIs performed similarly well. Our study suggests that CIs do not adequately risk-adjust for complications after colorectal surgery.
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