Evidence map›Paper›PMID 33125506›Full record

ArticleWorld journal of surgery2021

Development of a Clinical Prediction Model for In-hospital Mortality from the South African Cohort of the African Surgical Outcomes Study.

Hyla-Louise Kluyts, Wilhelmina Conradie, Estie Cloete, Sandra Spijkerman, Oliver Smith, Ahmed Alli, Modise Z Koto, Odisang D Montwedi, Komalan Govender, Larissa Cronjé and 27 more

Abstract readMulticenter Study
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In one paragraph

Article in World journal of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

37 authors at 20 institutions in 2 countries.

Hyla-Louise KluytsDepartment of Anaesthesiology, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa. hyla.kluyts@smu.ac.za.ORCID http://orcid.org/0000-0002-9917-1330
Wilhelmina ConradieDepartment of Surgery, Tygerberg Hospital, University of Stellenbosch, Cape Town, Western Cape Province, South Africa.
Estie CloeteDepartment of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, Western Cape Province, South Africa.
Sandra SpijkermanDepartment of Anaesthesiology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, Gauteng, South Africa.
Oliver SmithDepartment of Anaesthesia and Critical Care, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.
Ahmed AlliDepartment of Anaesthesia and Critical Care, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, Gauteng, South Africa.
Modise Z KotoDepartment of Anaesthesiology, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa.
Odisang D MontwediDepartment of Surgery, Kalafong Hospital, University of Pretoria, Pretoria, Gauteng, South Africa.
Komalan GovenderPrince Mshiyeni Memorial Hospital, Umlazi, KwaZulu-Natal, South Africa.
Larissa CronjéKing Edward VIII Hospital, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Mariette GrobbelaarEdendale Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa.
Jones A Omoshoro-JonesDepartment of Surgery, Chris Hani-Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
Nicolette F RorkeDepartment of Anaesthesiology, RK Khan Hospital, University of KwaZulu-Natal, eThekwini, KwaZulu-Natal, South Africa.
Philip AndersonKimberley Hospital Complex, University of the Free State, Kimberley, Northern Cape Province, South Africa.
Alexandra TorborgDepartment of Anaesthesiology, Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal, Durban, South Africa.
Christella AlphonsusDepartment of Anaesthesiology, Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal, Durban, South Africa.
Panagiotis AlexandrisPort Elizabeth Hospital Complex, Port Elizabeth, Eastern Cape Province, South Africa.
Aunel Mallier PeterKlerksdorp/Tshepong Hospital, University of the Witwatersrand, Klerksdorp, North West Province, South Africa.
Usha SinghDepartment of Anaesthesiology, Addington Hospital, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Johan DiedericksDepartment of Anaesthesiology, Universitas Hospital, University of the Free State, Bloemfontein, Free State, South Africa.
Busisiwe MraraDepartment of Anaesthesiology, Nelson Mandela Academic Hospital, Walter Sisulu University, Mthatha, Eastern Cape Province, South Africa.
Anthony ReedNew Somerset Hospital, University of Cape Town, Cape Town, Western Cape Province, South Africa.
Gareth L DaviesPaarl Provincial Hospital, Paarl, Western Cape Province, South Africa.
Jody G DavidsGeorge Regional Hospital, University of Cape Town, George, Western Cape Province, South Africa.
Hendrik A Van ZylDepartment of Anaesthesiology, Worcester Hospital, Worcester, Western Cape Province, South Africa.
Vishendran GovindasamyDepartment of Surgery, Grey's Hospital, Pietermaritzburg, KwaZulu-Natal, South Africa.
Reitze RodsethDepartment of Anaesthetics, Grey's Hospital, University of KwaZulu-Natal, Pietermaritzburg, KwaZulu-Natal, South Africa.
Roel Matos-PuigGeneral Justice Gizenga Mpanza Regional Hospital, Stanger, KwaZulu-Natal, South Africa.
Kajake A P BhatDepartment of Anaesthesiology, Cecilia Makiwane Hospital, Walter Sisulu University, East London Hospital Complex, Eastern Cape Province, South Africa.
Noel NaidooDepartment of Surgery, Port Shepstone Regional Hospital, University of KwaZulu-Natal, Port Shepstone, KwaZulu-Natal, South Africa.
John RoosDepartment of Anaesthesia, Mitchells Plain Hospital, Cape Town, South Africa.
Magdalena JaworskaHelderberg and Karl Bremer Hospitals, University of Stellenbosch, Cape Town, Western Cape Province, South Africa.
Annemarie SteynDepartment Anaesthesiology, Potchefstroom Hospital, Potchefstroom, North West Province, South Africa.
Johannes M DippenaarOral and Dental Hospital, University of Pretoria, Pretoria, Gauteng, South Africa.
R M PearseRoyal London Hospital, Queen Mary University of London, London, UK.
Thandinkosi MadibaUniversity of KwaZulu-Natal, Durban, South Africa.
Bruce M BiccardGroote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
University of Cape Town · ZAUniversity of KwaZulu-Natal · ZAUniversity of the Witwatersrand · ZAGrey's Hospital · ZASefako Makgatho Health Sciences University · ZAStellenbosch University · ZAUniversity of the Free State · ZAAddington Hospital · ZACecilia Makiwane Hospital · ZAEdendale Hospital · ZAKalafong Hospital · ZAKing Edward VIII Hospital · ZANelson Mandela Academic Hospital · ZANorth-West University · ZAPort Elizabeth Provincial Hospital · ZAR. K. Khan Hospital · ZAStanger Hospital · ZASteve Biko Hospital · ZAUniversity of Pretoria · ZAUniversity of Ulster · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundData on the factors that influence mortality after surgery in South Africa are scarce, and neither these data nor data on risk-adjusted in-hospital mortality after surgery are routinely collected. Predictors related to the context or setting of surgical care delivery may also provide insight into variation in practice. Variation must be addressed when planning for improvement of risk-adjusted outcomes. Our objective was to identify the factors predicting in-hospital mortality after surgery in South Africa from available data.

methodsA multivariable logistic regression model was developed to identify predictors of 30-day in-hospital mortality in surgical patients in South Africa. Data from the South African contribution to the African Surgical Outcomes Study were used and included 3800 cases from 51 hospitals. A forward stepwise regression technique was then employed to select for possible predictors prior to model specification. Model performance was evaluated by assessing calibration and discrimination. The South African Surgical Outcomes Study cohort was used to validate the model.

resultsVariables found to predict 30-day in-hospital mortality were age, American Society of Anesthesiologists Physical Status category, urgent or emergent surgery, major surgery, and gastrointestinal-, head and neck-, thoracic- and neurosurgery. The area under the receiver operating curve or c-statistic was 0.859 (95% confidence interval: 0.827-0.892) for the full model. Calibration, as assessed using a calibration plot, was acceptable. Performance was similar in the validation cohort as compared to the derivation cohort.

conclusionThe prediction model did not include factors that can explain how the context of care influences post-operative mortality in South Africa. It does, however, provide a basis for reporting risk-adjusted perioperative mortality rate in the future, and identifies the types of surgery to be prioritised in quality improvement projects at a local or national level.

Indexed as

Hospital MortalityModels, StatisticalAdultClinical Decision RulesDelivery of Health CareFemaleHealthcare DisparitiesHumansMaleMiddle AgedPrognosisRetrospective StudiesRisk AssessmentRisk FactorsSouth AfricaSurgical Procedures, Operative

Identifiers

PMID33125506
OpenAlexW3096503818

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.