Nomogram to predict risk of 30-day morbidity and mortality for patients with disseminated malignancy undergoing surgical intervention

Annals of Surgery
Warren H TsengRobert J Canter

Abstract

To estimate individual risk of 30-day surgical morbidity and mortality after surgical intervention for patients with disseminated malignancy (DMa). Patients with DMa frequently require surgical consultation for palliative operations. Although these patients are at high risk for surgical morbidity and mortality, limited data exist allowing individual risk stratification. Using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) from 2005 to 2007, we identified 7447 patients with DMa. Each of the 53 preoperative ACS NSQIP variables was analyzed to assess risk of morbidity and mortality. Logistic regression models were developed using stepwise model selection and generalized additive models. Covariates were evaluated for nonlinearity and interactions among variables. We constructed nomograms utilizing clinically and statistically significant covariates to predict 30-day risk of morbidity and mortality. Overall 30-day unadjusted morbidity and mortality rates were 28.3% and 8.9%, respectively. Mortality rates reached 18.4% for vascular procedures and 27.9% for emergent operations. Increasing age, impaired functional status, Do-Not-Resuscitate status, impaired respiratory function, ascites, hypo...Continue Reading

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Citations

Sep 20, 2012·Annals of Surgical Oncology·Valerie FrancescuttiKelli Bullard Dunn
Jan 15, 2014·Journal of Palliative Medicine·Robert E RosesY Nancy You
Mar 24, 2012·Journal of the American College of Surgeons·Ryan P MerkowKarl Y Bilimoria
Mar 13, 2012·Anesthesiology Clinics·Geoffrey P Dunn
Mar 23, 2011·The Surgical Clinics of North America·Geoffrey P Dunn
Nov 21, 2012·The British Journal of Surgery·K C FearonK Lassen
Apr 15, 2016·Asia-Pacific Journal of Clinical Oncology·Deanna Wan Jie NgTing Hway Wong
Apr 29, 2015·The Journal of Surgical Research·Sarah B BateniRobert J Canter
Jun 22, 2016·Journal of Palliative Medicine·Rodrigo Andres RodriguezKatherine T Morris
Jul 10, 2016·Journal of Surgical Oncology·Ian W Folkert, Robert E Roses
Oct 27, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Lauren M WancataSamantha Hendren
Jul 17, 2014·Plastic and Reconstructive Surgery·John P FischerStephen J Kovach
May 28, 2019·Journal of Surgical Oncology·Joshua T Cohen, Thomas J Miner
Nov 13, 2020·Female Pelvic Medicine & Reconstructive Surgery·Rubin RajuJohn A Occhino
Jun 1, 2021·Surgical Oncology Clinics of North America·Cassandra S Parker, Thomas J Miner

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