ArticleJournal of surgical oncology (Tallinn, Estonia)2020
The Cumulative Perioperative Model: Predicting 30-Day Mortality in Abdominal Surgery Cancer Patients.
Article in Journal of surgical oncology (Tallinn, Estonia), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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4 authors at 2 institutions in 1 country.
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Abstract
objectives1) To develop a cumulative perioperative model (CPM) using the hospital clinical course of abdominal surgery cancer patients that predicts 30 and 90-day mortality risk; 2) To compare the predictive ability of this model to ten existing other models. MATERIALS AND
methodsWe constructed a multivariate logistic regression model of 30 (90)-day mortality, which occurred in 106 (290) of the cases, using 13,877 major abdominal surgical cases performed at the University of Texas MD Anderson Cancer Center from January 2007 to March 2014. The model includes race, starting location (home, inpatient ward, intensive care unit or emergency center), Charlson Comorbidity Index, emergency status, ASA-PS classification, procedure, surgical Apgar score, destination after surgery (hospital ward location) and delayed intensive care unit admit within six days. We computed and compared the model mortality prediction ability (C-statistic) as we accumulated features over time.
resultsWe were able to predict 30 (90)-day mortality with C-statistics from 0.70 (0.71) initially to 0.87 (0.84) within six days postoperatively.
conclusionWe achieved a high level of model discrimination. The CPM enables a continuous cumulative assessment of the patient's mortality risk, which could then be used as a decision support aid regarding patient care and treatment, potentially resulting in improved outcomes, decreased costs and more informed decisions.
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