更新基于国家临床数据库的低前置切除后死亡率和发病率的预测模型
Kazushige Kawai1,2, Shinya Hirakawa3,4, Hisateru Tachimori3,4
1Department of Colorectal Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
Digestive surgery
|June 13, 2023
概括
这项研究更新了日本低前切除后死亡率和发病率的风险模型. 新模型提高了短期结果的预测准确性,有助于临床决策.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术结果研究研究.
- 医疗信息学 医疗信息学
背景情况:
- 由于外科手术实践发生了重大变化,日本低前切除 (LAR) 之前的风险模型已经过时.
- 需要更新风险预测工具来预测LAR后的短期术后结果.
研究的目的:
- 构建和验证低前切除后六种短期术后结果的新风险预测模型.
- 包括住院死亡率,30天死亡率,静脉泄漏,手术部位感染,整体术后并发症和30天重新手术率.
主要方法:
- 利用来自日本国家临床数据库的2014年至2019年间接受低前切除的120912名患者的数据.
- 采用多重后勤回归分析来开发包含手术前变量,包括TNM分期的预测模型.
主要成果:
- 开发了针对整体术后并发症和30天复手率的新型风险预测模型.
- 在所有结果中实现了高预测准确度,一致性指数从0.62到0.82不等.
- 证明了先前在早期风险计算器中包含的模型的改进一致性指数.
结论:
- 成功更新了风险计算器,用于预测低前切除后的死亡率和发病率.
- 基于广泛的日本全国数据的更新模型为评估短期术后风险提供了可靠的工具.
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