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Evaluating the ACS-NSQIP Risk Calculator in Primary GI Neuroendocrine Tumor: Results from the United States Neuroendocrine Tumor Study Group.

التفاصيل البيبلوغرافية
العنوان: Evaluating the ACS-NSQIP Risk Calculator in Primary GI Neuroendocrine Tumor: Results from the United States Neuroendocrine Tumor Study Group.
المؤلفون: Armstrong EA; From the *Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio., Beal EW; From the *Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio., Lopez-Aguiar AG; †Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, Georgia., Poultsides G; ‡Department of Surgery, Stanford University, Palo Alto, California., Cannon JG; ‡Department of Surgery, Stanford University, Palo Alto, California., Rocha F; §Department of Surgery, Virginia Mason Medical Center, Seattle, Washington., Crown A; §Department of Surgery, Virginia Mason Medical Center, Seattle, Washington., Barrett J; ¶Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Ronnkleiv-Kelly S; ¶Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Fields RC; ║Department of Surgery, Washington University School of Medicine, St. Louis, Michigan., Krasnick BA; ║Department of Surgery, Washington University School of Medicine, St. Louis, Michigan., Idrees K; #Division of Surgical Oncology, Department of Surgery, Vanderbilt University, Nashville, Tennessee; and., Smith PM; #Division of Surgical Oncology, Department of Surgery, Vanderbilt University, Nashville, Tennessee; and., Nathan H; *Division of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan., Beems MV; *Division of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan., Maithel SK; †Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, Georgia., Schmidt CR; From the *Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio., Pawlik TM; From the *Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio., Dillhoff M; From the *Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio.
المصدر: The American surgeon [Am Surg] 2019 Dec 01; Vol. 85 (12), pp. 1334-1340.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: SAGE Publications in association with Southeastern Surgical Congress Country of Publication: United States NLM ID: 0370522 Publication Model: Print Cited Medium: Internet ISSN: 1555-9823 (Electronic) Linking ISSN: 00031348 NLM ISO Abbreviation: Am Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: 2020- : [Thousand Oaks, CA] : SAGE Publications in association with Southeastern Surgical Congress
Original Publication: Atlanta Ga : Southeastern Surgical Congress
مواضيع طبية MeSH: Gastrointestinal Neoplasms/*diagnosis , Neuroendocrine Tumors/*diagnosis , Risk Assessment/*methods, Aged ; Aged, 80 and over ; Female ; Gastrointestinal Neoplasms/complications ; Gastrointestinal Neoplasms/mortality ; Gastrointestinal Neoplasms/surgery ; Humans ; Male ; Middle Aged ; Neuroendocrine Tumors/complications ; Neuroendocrine Tumors/mortality ; Neuroendocrine Tumors/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; ROC Curve ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; United States
مستخلص: The ACS established an online risk calculator to help surgeons make patient-specific estimates of postoperative morbidity and mortality. Our objective was to assess the accuracy of the ACS-NSQIP calculator for estimating risk after curative intent resection for primary GI neuroendocrine tumors (GI-NETs). Adult patients with GI-NET who underwent complete resection from 2000 to 2017 were identified using a multi-institutional database, including data from eight academic medical centers. The ability of the NSQIP calculator to accurately predict a particular outcome was assessed using receiver operating characteristic curves and the area under the curve (AUC). Seven hundred three patients were identified who met inclusion criteria. The most commonly performed procedures were resection of the small intestine with anastomosis (N = 193, 26%) and partial colectomy with anastomosis (N = 136, 18%). The majority of patients were younger than 65 years (N = 482, 37%) and ASA Class III (N = 337, 48%). The most common comorbidities were diabetes (N = 128, 18%) and hypertension (N = 395, 56%). Complications among these patients based on ACS NSQIP definitions included any complication (N = 132, 19%), serious complication (N = 118, 17%), pneumonia (N = 7, 1.0%), cardiac complication (N = 1, 0.01%), SSI (N = 80, 11.4%), UTI (N = 17, 2.4%), venous thromboembolism (N = 18, 2.5%), renal failure (N = 16, 2.3%), return to the operating room (N = 27, 3.8%), discharge to nursing/rehabilitation (N = 22, 3.1%), and 30-day mortality (N = 9, 1.3%). The calculator provided reasonable estimates of risk for pneumonia (AUC = 0.721), cardiac complication (AUC = 0.773), UTI (AUC = 0.716), and discharge to nursing/rehabilitation (AUC = 0.779) and performed poorly (AUC < 0.7) for all other complications Fig. 1). The ACS-NSQIP risk calculator estimates a similar proportion of risk to actual events in patients with GI-NET but has low specificity for identifying the correct patients for many types of complications. The risk calculator may require modification for some patient populations.
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معلومات مُعتمدة: K12 CA090625 United States CA NCI NIH HHS
تواريخ الأحداث: Date Created: 20200108 Date Completed: 20200116 Latest Revision: 20230519
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10188290
PMID: 31908214
قاعدة البيانات: MEDLINE
الوصف
تدمد:1555-9823