ACS NSQIP手术风险计算器预测开腹宫颈癌根治术手术风险的价值

doi:10.3969/j.issn.1006-5725.2024.02.003

Abstract

Abstract:

Objectives To evaluate the complications predicting efficacy of the American College of Surgeons （ACS） National Surgical Quality Improvement Program （NSQIP） surgical risk calculator for cervical cancer patients undergoing open radical hysterectomy in China. Methods This study enrolled the cervical cancer patients （139 cases） undertaken open radical hysterectomy at Women's Hospital of Nanjing Medical University from January to December in 2021. Preoperative risk factors were abstracted from medical records and the surgical risk scores were calculated using ACS NSQIP surgical risk calculator. The association between risk scores and actual outcomes were assessed using logistic regression together with the c-statistic （area under ROC） and Brier score. Results The ACSNSQIP calculator did not predict accurately for serious complications， any complications， venous thromboembolism （VTE）， readmission， return operation room and surgical site infection （SSI） compared with actual outcomes. There was significantly difference in the predicted and actual length of stay （3.93 ± 0.42 days vs. 13.11 ± 4.71 days， P < 0.001）. Conclusions The ACS NSQIP surgical risk calculator failed to predict the postoperative complications and the length of hospital stay for cervical cancer patients undergoing open radical hysterectomy.

Key words: cervical cancer, open radical hysterectomy, post-operative complications, surgical risk calculator

CLC Number:

R713.4

Shenglong YUAN,Huanhuan HU,Zhen GONG. Efficacy of the ACS NSQIP surgical risk calculator in open radical hysterectomy[J]. The Journal of Practical Medicine, 2024, 40(2): 140-145.

Figures/Tables 5

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References 31

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特征	例数（n = 139）	百分比（%）
年龄
< 65 岁	126	90.6
65 ~ 74岁	13	9.4
75 ~ 84岁	0	0
> 85岁	0	0
功能状态
独立	139	100
部分依赖	0	0
完全依赖	0	0
ASA 分级
健康（ASA1）	138	99.3
轻度全身性疾病（ASA 2）	0	0
严重全身性疾病（ASA 3）	1	0.7
危及生命（ASA 4）	0	0
使用类固醇治疗慢性病	0	0
腹水	0	0
糖尿病
否	128	92.1
口服降糖药	6	4.3
应用胰岛素	5	3.6
需要药物治疗的高血压	24	17.3
术前30 d内的充血性心力衰竭	0	0
呼吸困难	0	0
吸烟	1	0.7
严重慢性阻塞性肺疾病病史	0	0
透析	0	0
急性肾衰竭	0	0
体质量指数
< 18.5 kg/m²	3	2.2
≥ 18.5且< 25 kg/m²	91	65.5
≥ 25且< 29.9 kg/m²	39	28.1

结局	实际（%）	比值比（95%CI）	c-statistic［95%CI］	Brier score
总体并发症	5.8	0.382（0.012 ~ 1.641）	0.486［0.460 ~ 0.512］	0.054
严重并发症	2.2	0.895（0.017 ~ 2.649）	0.420［0.383 ~ 0.458］	0.021
切口感染	3.6	1.588（0.158 ~ 7.217）	0.681［0.654 ~ 0.709］	0.035
静脉血栓	1.4	0（0 ~ 557.441）	0.650［0.642 ~ 0.657］	0.014
再入院	2.9	1.223（0.142 ~ 3.153）	0.661［0.629 ~ 0.693］	0.027
二次手术	0.7	0（0 ~ 19941.313）	0.594［0.588 ~ 0.600］	0.007

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Efficacy of the ACS NSQIP surgical risk calculator in open radical hysterectomy

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