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. 2022 Nov 10:21:11769351221135153.
doi: 10.1177/11769351221135153. eCollection 2022.

Contextual Validation of the Prediction of Postoperative Complications of Colorectal Surgery by the " ACS NSQIP ® Risk Calculator" in a Tunisian Center

Mehdi Ben Abdelkrim  1   2 , Mohamed Amine Elghali  1   2   3 , Amany Moussa  1 , Ahmed Ben Abdelaziz  2   3   4
Affiliations

Contextual Validation of the Prediction of Postoperative Complications of Colorectal Surgery by the " ACS NSQIP ® Risk Calculator" in a Tunisian Center

Mehdi Ben Abdelkrim et al. Cancer Inform. .

Abstract

Context: Models for predicting individual risks of surgical complications are advantageous for operative decision making and the nature of postoperative management procedures.

Objective: Validate the "ACS NSQIP® Risk Calculator" in the prediction of postoperative complications during colorectal cancer surgery, operated during the years 2015 to 2019.

Methods: this is a prognostic validation study of the "ACS NSQIP®" applied retrospectively to patients operated on for colorectal cancer in the surgical department of Farhat Hached hospital, during the 2015 and 2019 5-year term. Three levels of adjustment. Discrimination and calibration were carried out mainly by ROC curves (AUC ⩾ 0.8).

Results: In this study, 129 patients were included with a sex ratio of 1.22 and a median age of 62 years. The most common operative procedure was low segmental colectomy with colorectal anastomosis. Thirty-seven patients (28.7%) had at least one postoperative complication. The prediction and cuts-off points values of mortality (AUC = 0.858; CI95% [0.570-0.960]; Cuts-off points = 1.8%), cardiac complications (AUC = 0.824; CI95% [0.658-0.990]; Cuts-off points = 1.8%), thromboembolic complications (AUC = 0.802; CI95% [0.617-0.987]; Cuts-off point = 3.1%), and renal insufficiency (AUC = 0.802; CI95% [ 0.623-0.981]; Cuts-off point = 1.2%) were adjusted according to level 1 of the calculator.

Conclusion: This work contextualized the prediction of postoperative complications in colorectal surgery in the university general surgery department of Farhat Hached in Sousse (Tunisia), making it possible to improve the quality and safety of surgical care. The application of the Tunisian mini calculator is recommended as well as the generalization of validation following the development of a generic calculator for all operating procedures.

Keywords: General surgery; ROC curve; Tunisia; colorectal surgery; colorectal tumors; health care quality; morbidity; postoperative complications -mortality; prognosis.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
ROC curves for postoperative complications of colorectal cancer surgery in the general surgery department of Farhat Hached in Sousse, Tunisia between the years 2015 and 2019, for level 1 adjustment of the “ACS NSQIP® Risk Calculator.”
Box 1.
Box 1.
Risk assessment grid for patients with colorectal tumors in the general surgery department of CHU Farhat Hached in Sousse (Tunisia).
See this image and copyright information in PMC

References

    1. Varadhan KK, Neal KR, Dejong CH, Fearon KC, Ljungqvist O, Lobo DN. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr. 2010;29:434-440. - PubMed
    1. Park JH, Kim DH, Kim BR, Kim YW. The American Society of Anesthesiologists score influences on postoperative complications and total hospital charges after laparoscopic colorectal cancer surgery. Medicine. 2018;97:e0653. - PMC - PubMed
    1. Arfaoui Toumi A, Kriaa Ben Mahmoud L, Khiari M, et al.. [Epidemiological study, pathologic evaluation and prognostic factors of colorectal mucinous vs non-mucinous adenocarcinoma (a series of 196 patients)]. Tunis Med. 2010;88:12-17. - PubMed
    1. World Health Organization. Global cancer epidemiology 2021. https://www.who.int/fr/news-room/fact-sheets/detail/cancer
    1. World Health Organization. Profile of cancers in Tunisia. https://cdn.who.int/media/docs/default-source/country-profiles/cancer/tu...

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