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. 2019 Apr 22;3(4):405-415.
doi: 10.1002/ags3.12248. eCollection 2019 Jul.

Risk calculator for predicting postoperative pneumonia after gastroenterological surgery based on a national Japanese database

Yoshio Takesue  1 , Hiroaki Miyata  2 , Mitsukazu Gotoh  1 , Go Wakabayashi  1 , Hiroyuki Konno  2 , Masaki Mori  1 , Hiraku Kumamaru  1 , Takashi Ueda  1 , Kazuhiko Nakajima  1 , Motoi Uchino  1 , Yasuyuki Seto  1
Affiliations

Risk calculator for predicting postoperative pneumonia after gastroenterological surgery based on a national Japanese database

Yoshio Takesue et al. Ann Gastroenterol Surg. .

Abstract

Background: The aim of the present study was to develop a risk calculator predictive of postoperative pneumonia in patients undergoing gastroenterological surgery.

Methods: We analyzed data from 382 124 patients undergoing eight main gastroenterological surgeries between 2011 and 2013 using the National Clinical Database in Japan. A risk model was developed using multivariate logistic regression analysis with patient data from 2011 to 2012 (n = 247 604) and validated using data from 2013 (n = 134 520).

Results: Pneumonia was observed in 11 105 patients (2.9%). After the input of significant primary disease and surgical procedures, 18 patient characteristics including gender, chronic obstructive pulmonary disease, sepsis, and need for any assistance in the activities of daily living, six laboratory parameters, and two intraoperative factors were used for risk calculation. Area under the receiver-operating characteristic curve was 0.822 (95% confidence interval, 0.817-0.826) in the derivation group and 0.826 (0.819-0.832) in the validation group.

Conclusion: The risk calculator accurately predicted the occurrence of pneumonia following gastroenterological surgery.

Keywords: National Clinical Database; gastroenterological surgery; pneumonia; postoperative complication; risk model.

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Figures

Figure 1
Figure 1
Approximated predicted risk for postoperative pneumonia. Risk for postoperative pneumonia is approximated from a nomogram of predicted probability vs calculated total risk score. βi is the coefficient of the variable Xi in the logistic regression equation provided in Table 4
Figure 2
Figure 2
Receiver‐operating characteristic (ROC) curve for postoperative pneumonia in the derivation and validation groups. Area under the ROC curve was 0.822 (95% CI, 0.817‐0.826) in the derivation subset of the study sample and 0.826 (95% CI, 0.819‐0.832) in the validation subset of the study sample
Figure 3
Figure 3
Calibration of the postoperative pneumonia model. Bar charts represent mean rate for the predicted events. Line chart represents those for the observed events, and the error bars represent 95% CI of the observed events. The risk score is calculated using Σ [βi × X i]. βi is the coefficient of the variable Xi in the logistic regression equation. This figure represents how well the rates of the predicted events matched those of the observed events according to the patient risk subgroups
See this image and copyright information in PMC

References

    1. Watanabe T, Miyata H, Konno H, Kawai K, Ishihara S, Sunami E, et al. Prediction model for complications after low anterior resection based on data from 33,411 Japanese patients included in the National Clinical Database. Surgery. 2017;161:1597–608. - PubMed
    1. Kinlin LM, Kirchner C, Zhang H, Daley J, Fisman DN. Derivation and validation of a clinical prediction rule for nosocomial pneumonia after coronary artery bypass graft surgery. Clin Infect Dis. 2010;50:493–501. - PubMed
    1. Strobel RJ, Liang Q, Zhang M, Wu X, Rogers MA, Theurer PF, et al. Michigan Society Of Thoracic And Cardiovascular Surgeons Quality Collaborative.: a preoperative risk model for postoperative pneumonia after coronary artery bypass grafting. Ann Thorac Surg. 2016;102:1213–9. - PMC - PubMed
    1. Allou N, Bronchard R, Guglielminotti J, Dilly MP, Provenchere S, Lucet JC, et al. Risk factors for postoperative pneumonia after cardiac surgery and development of a preoperative risk score. Crit Care Med. 2014;42:1150–6. - PubMed
    1. Gupta H, Gupta PK, Schuller D, Fang X, Miller WJ, Modrykamien A, et al. Development and validation of a risk calculator for predicting postoperative pneumonia. Mayo Clin Proc. 2013;88:1241–9. - PubMed

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