TY - JOUR
AR - COR-2020-5-104
TI - The Utility of a Personalised Risk Calculator in Gynae-Oncology Surgery
AU - Inés , Murray
AU - Kenneth , Lim
AU - Robert , Howells
AU - Rhidian , Jones
AU - Aarti , Sharma
AU - Sadie, Jones
JO - Clinical Oncology and Research
PY - 2020
DA - Fri 27, Nov 2020
SN - 2613-4942
DO - http://dx.doi.org/10.31487/j.COR.2020.05.04
UR - https://www.sciencerepository.org/the-utility-of-a-personalised-risk-calculator-in-gynae-oncology-surgery_COR-2020-5-104 
KW - Surgical risk, gynaecology-oncology
AB - 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.