Pre-operative nomogram to predict risk of peri-operative mortality following liver resections for malignancy.
J Gastrointest Surg
; 14(11): 1770-81, 2010 Nov.
Article
en En
| MEDLINE
| ID: mdl-20824363
ABSTRACT
INTRODUCTION:
The majority of liver resections for malignancy are performed in older patient with major co-morbidities. There is currently no pre-operative, patient-specific method to determine the likely peri-operative mortality for each individual patient. The aim of this study was to develop a pre-operative nomogram based on the presence of co-morbidities to predict risk of peri-operative mortality following liver resections for malignancy.METHODS:
The Nationwide Inpatient Sample database was queried to identify adult patients that underwent liver resection for malignancy. The pre-operative co-morbidities, identified as predictors were used and a nomogram was created with multivariate regression using Taylor expansion method in SAS software, surveylogistic procedure. Training set (years 2000-2004) was utilized to develop the model and validation set (year 2005) was utilized to validate this model.RESULTS:
A total of 3,947 and 972 patients were included in training and validation sets, respectively. The overall actual-observed peri-operative mortality rates for training and validation sets were 4.1% and 3.2%, respectively. The decile-based calibration plots for the training set revealed good agreement between the observed probabilities and nomogram-predicted probabilities. Similarly, the quartile-based calibration plot for the validation set revealed good agreement between the observed and predicted probabilities. The accuracy of the nomogram was further reinforced by a good concordance index of 0.80 with a 95% confidence interval of 0.72 and 0.87.CONCLUSIONS:
This pre-operative nomogram may be utilized to predict the risk of peri-operative mortality following liver resection for malignancy.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Nomogramas
/
Hepatectomía
/
Neoplasias Hepáticas
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Gastrointest Surg
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2010
Tipo del documento:
Article
País de afiliación:
Estados Unidos