The Revised ACPGBI Model is a Simple and Accurate Predictor of Operative Mortality After Potentially Curative Resection of Colorectal Cancer
The Revised ACPGBI Model is a Simple and Accurate Predictor of Operative Mortality After Potentially Curative Resection of Colorectal Cancer
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DOI：
10.1245/s10434-011-1805-1
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发表时间：
2011-12-01
影响因子：
3.7
通讯作者：
Horgan, Paul G.
中科院分区：
文献类型：
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作者：
Richards, Colin H.;Leitch, E. Fiona;Horgan, Paul G.
英国和爱尔兰结直肠癌协会(ACPGBI)结直肠癌手术风险调整模型最近进行了修订。本研究的目的是比较修正的ACPGBI模型、原始的ACPGBI模型、P-POSSUM和CR-POSSUM在预测结直肠癌切除术后死亡率方面的表现。前瞻性地收集了用于构建ACPGBI模型的数据。通过检验观察值与期望值(O：E)比、Hosmer-Lemesshow(H-L)拟合度检验和受试者特征曲线下面积分析对模型进行比较。30天死亡率为4%。模型的性能分别为：修正的ACPGBI模型(O：E比=1.0 5，AUC=0.73，H-L=11.02)，原始ACPGBI模型(O：E比=0.5 8，AUC=0.76，H-L=14.2 3)，P-POSSUM模型(O：E比=0.87，AUC=0.79，H-L=10.6 3)，CR-POSSUM模型(O：E比=0.6 3，AUC=0.84，H-L=15.84)。在亚组分析中，修正的ACPGBI模型在择期病例(O：E比=1.06)和急诊病例(O：E比=0.91)中都表现良好。修正的ACPGBI模型构建简单，能准确预测结直肠癌根治术后的手术死亡率。
The Association of Coloproctology of Great Britain and Ireland (ACPGBI) risk-adjustment model for colorectal cancer surgery has been recently revised. The aim of the present study was to compare the performance of the revised ACPGBI model, the original ACPGBI model, P-POSSUM, and CR-POSSUM, in the prediction of operative mortality after resection of colorectal cancer.A total of 423 patients who underwent potentially curative resection of colorectal cancer at a single institution (1997-2007) were included. Data used in the construction of the ACPGBI model was collected prospectively. The models were compared by examining observed to expected (O:E) ratios, the Hosmer-Lemeshow (H-L) goodness-of-fit test, and area under the receiver operator characteristic curve (AUC) analysis.The 30-day mortality rate was 4%. The performance of the models was as follows: revised ACPGBI model (O:E ratio = 1.05, AUC = 0.73, H-L = 11.02), original ACPGBI model (O:E ratio = 0.58, AUC = 0.76, H-L = 14.23), P-POSSUM (O:E ratio = 0.87, AUC = 0.79, H-L = 10.63), and CR-POSSUM (O:E ratio = 0.63, AUC = 0.84, H-L = 15.84). In subgroup analysis, the revised ACPGBI model performed well in both elective cases (O:E ratio = 1.06) and emergency cases (O:E ratio = 0.91).The revised ACPGBI model is simple to construct and accurately predicts operative mortality after potentially curative resection of colorectal cancer.