The Utility of a Personalised Risk Calculator in Gynae-Oncology Surgery

Author Info

Inés Murray Kenneth Lim Robert Howells Rhidian Jones Aarti Sharma Sadie Jones

Corresponding Author

Sadie Jones
Department of Gynaecology Oncology, University Hospital Wales, Cardiff, Wales, UK

A B S T R A C T

Objective: The objective of this study was to assess the ability of the American College of Surgeons (ACS) NSQIP surgical risk calculator to accurately identify patients at increased risk of perioperative complication following surgery for gynaecological malignancy. Methods: A retrospective review of 142 patients who underwent major surgery under the gynae-oncology team between 06/08/2018-16/04/2019 at the University Hospital of Wales. Pre-operative factors combined with a procedure-specific code generated the predicted risk of 13 post-operative complications for each patient. Brier scores assessed calibration and receiver operated curves (AUC) evaluated the discriminative power of NSQIP. Results: Complications were experienced by 50/142 (35.2%) patients. The calculator displayed adequate calibration when used to predict serious complications (Brier = 0.070), readmission (Brier = 0.058), return to OR (Brier = 0.000) and UTI (Brier = 0.001). It had the greatest discriminative power when predicting the risk of serious complications (AUC = 0.672; 95% CI, 0.481-0.863). The calculator successfully identified a majority of patients who had a complication as being of ‘above average risk’ for all complications, apart from return to OR, based on their pre-operative factors. Discussion: NSQIP has previously been demonstrated to be a useful pre-operative tool for evaluating the risk of post-operative complications in colorectal surgery. This study suggests that in the setting of gynaeoncology surgery the calculator does not have adequate discriminative power to be an absolute predictor of all complications, however, it may be useful in identifying patients who are likely to develop serious complications and those at above average risk of complications.

Article Info

Article Type

Research Article

Publication history

Received: Thu 16, Apr 2020
Accepted: Mon 04, May 2020
Published: Fri 27, Nov 2020

Copyright

© 2023 Sadie Jones. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.COR.2020.05.04