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Multicentre Validation of the RESECT-90 Prediction Model for 90-Day Mortality After Lung Resection
Marcus Taylor1, Glen P Martin2, Udo Abah3
1Department of Cardiothoracic Surgery, Manchester University Hospital NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom; Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
The RESECT-90 model for predicting lung resection mortality shows good discrimination but needs recalibration for accurate UK-wide use. After recalibration, the model demonstrated excellent performance for predicting 90-day mortality.
Area of Science:
- Thoracic surgery
- Clinical prediction models
- Health outcomes research
Background:
- The RESECT-90 model predicts 90-day mortality after lung resection but requires external validation.
- Previous validation was limited, necessitating assessment in a broader patient cohort.
Purpose of the Study:
- To externally validate the RESECT-90 clinical prediction model.
- To assess the model's performance in a United Kingdom (UK) multicentre setting.
- To recalibrate the model if necessary to improve accuracy.
Main Methods:
- Utilized data from 12 UK thoracic surgery centers (2016-2020).
- Assessed discrimination (AUC) and calibration (slope, intercept, plots).
- Performed model recalibration by updating coefficients.
Main Results:
- Included 12,241 patients; 90-day mortality was 2.9%.
- Demonstrated acceptable discrimination (AUC 0.74).
- Observed initial miscalibration (slope 0.80, intercept 0.40) that improved to excellent performance post-recalibration.
Conclusions:
- The RESECT-90 model, after external validation and recalibration, shows satisfactory statistical performance for predicting 90-day mortality post-lung resection.
- Recalibration significantly improved model calibration across diverse UK centers.
- Routine use of the recalibrated RESECT-90 model in UK thoracic surgery practice is recommended, pending ongoing validation.
