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Validation of the ACS NSQIP Surgical Risk Calculator for Patients with Early Gastric Cancer Treated with Laparoscopic Gastrectomy

Journal of Gastric Cancer 2020년 20권 3호 p.267 ~ 276
Alzahrani Saleh M., 고창석, 유문원,
소속 상세정보
 ( Alzahrani Saleh M. ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
고창석 ( Ko Chang-Seok ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
유문원 ( Yoo Moon-Won ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery

Abstract


Purpose: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator is useful in predicting postoperative adverse events. However, its accuracy in specific disorders is unclear. We validated the ACS NSQIP risk calculator in patients with gastric cancer undergoing curative laparoscopic surgery.

Materials and Methods: We included 207 consecutive early gastric cancer patients who underwent laparoscopic gastrectomy between January 2018 and January 2019. The preoperative characteristics and risks of the patients were reviewed and entered into the ACS NSQIP calculator. The estimated risks of postoperative outcomes were compared with the observed outcomes using C-statistics and Brier scores.

Results: Most of the patients underwent distal gastrectomy with Roux-en-Y reconstruction (74.4%). We did not observe any cases of mortality, venous thromboembolism, urinary tract infection, renal failure, or cardiac complications. The other outcomes assessed were complications such as pneumonia, surgical site infections, any complications requiring re-operation or hospital readmission, the rates of discharge to nursing homes/rehabilitation centers, and the length of stay. All C-statistics were <0 and the highest was for pneumonia (0.65; 95% confidence interval: 0.58?0.71). Brier scores ranged from 0.01 for pneumonia to 0.155 for other complications. Overall, the risk calculator was inconsistent in predicting the outcomes.

Conclusions: The ACS NSQIP surgical risk calculator showed low predictive ability for postoperative adverse events after laparoscopic gastrectomy for patients with early gastric cancer. Further research to adjust the risk calculator for these patients may improve its predictive ability.

키워드

Gastric cancer; Laparoscopic surgery; Gastrectomy; Postoperative complication; Patient outcome assessment

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