Validation study of the ACS NSQIP surgical risk calculator for two procedures in Japan
Validation study of the ACS NSQIP surgical risk calculator for two procedures in Japan
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DOI：
10.1016/j.amjsurg.2021.06.008
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发表时间：
2021-11-29
影响因子：
3
通讯作者：
Cohen, Mark E.
中科院分区：
文献类型：
--
作者：
Ma, Meixi;Liu, Yaoming;Cohen, Mark E.
简介：ACS NSQIP手术风险计算器（SRC）评估风险，以支持目标一致的护理。虽然它准确地预测了美国的结果，但其国际表现尚不清楚。本研究评价了SRC预测NSQIP患者低位前切除术（LAR）和胰腺切除术（PD）后死亡率的准确性，以及应用于日本本土患者时的准确性保留（国家临床数据库，NCD）。通过SRC死亡率模型处理了2015年至2017年的41，260例LAR; 15，114例PD）和NCD病例（61，220例LAR; 27，901例PD）。国家特定的校准和歧视进行了评估，没有截距校正适用于日本data.Results：SRC表现出可接受的校准LAR和PD时，适用于NSQIP数据，但误校准NCD数据。一个简单的校正模型截距，在日本的数据，低死亡率的动机，成功地补救了miscalibration.Conclusions：SRC可能不准确地预测手术风险时，适用于日本本土人口。一个拦截校正方法，建议当遇到误校准，它是简单的实施，并可能允许有效的国际使用的SRC。(C)2021爱思唯尔公司All rights reserved.
Introduction: The ACS NSQIP Surgical Risk Calculator (SRC) assesses risk to support goal-concordant care. While it accurately predicts US outcomes, its performance internationally is unknown. This study evaluates SRC accuracy in predicting mortality following low anterior resection (LAR) and pancreaticoduodenectomy (PD) in NSQIP patients and accuracy retention when applied to native Japanese patients (National Clinical Database, NCD).Methods: NSQIP (41,260 LAR; 15,114 PD) and NCD cases (61,220 LAR; 27,901 PD) from 2015 to 2017 were processed through the SRC mortality model. Country-specific calibration and discrimination were assessed with and without an intercept correction applied to the Japanese data.Results: The SRC exhibited acceptable calibration for LAR and PD when applied to NSQIP data but miscalibration for NCD data. A simple correction to the model intercept, motivated by lower mortality rates in the Japanese data, successfully remediated the miscalibration.Conclusions: The SRC may inaccurately predict surgical risk when applied to the native Japanese population. An intercept correction method is suggested when miscalibration is encountered; it is simple to implement and may permit effective international use of the SRC. (C) 2021 Elsevier Inc. All rights reserved.