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External Validation of the American College of Surgeons Surgical Risk Calculator in Elderly Patients Undergoing General Surgery Operations

Title: External Validation of the American College of Surgeons Surgical Risk Calculator in Elderly Patients Undergoing General Surgery Operations
Authors: Stamatios Kokkinakis; Alexandros Andreou; Maria Venianaki; Charito Chatzinikolaou; Emmanuel Chrysos; Konstantinos Lasithiotakis
Source: Journal of Clinical Medicine, Vol 11, Iss 7083, p 7083 (2022)
Publisher Information: MDPI AG
Publication Year: 2022
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: geriatric surgery; risk assessment; validation; postoperative outcome; Medicine
Description: Preoperative risk stratification in the elderly surgical patient is an essential part of contemporary perioperative care and can be done with the use of the American College of Surgeons Surgical Risk Calculator (ACS-SRC). However, data on the generalizability of the ACS-SRC in the elderly is scarce. In this study, we report an external validation of the ACS-RC in a geriatric cohort. A retrospective analysis of a prospectively maintained database was performed including patients aged > 65 who underwent general surgery procedures during 2012–2017 in a Greek academic centre. The predictive ability of the ACS-SRC for post-operative outcomes was tested with the use of Brier scores, discrimination, and calibration metrics. 471 patients were included in the analysis. 30-day postoperative mortality was 3.2%. Overall, Brier scores were lower than cut-off values for almost all outcomes. Discrimination was good for serious complications (c-statistic: 0.816; 95% CI: 0.762–0.869) and death (c-statistic: 0.824; 95% CI: 0.719–0.929). The Hosmer-Lemeshow test showed good calibration for all outcomes examined. Predicted and observed length of stay (LOS) presented significant differences for emergency and for elective cases. The ACS-SRC demonstrated good predictive performance in our sample and can aid preoperative estimation of multiple outcomes except for the prediction of post-operative LOS.
Document Type: article in journal/newspaper
Language: English
Relation: https://www.mdpi.com/2077-0383/11/23/7083; https://doaj.org/toc/2077-0383; https://doaj.org/article/ea5103a6bf1a4680a09ea1cd5fdae0b5
DOI: 10.3390/jcm11237083
Availability: https://doi.org/10.3390/jcm11237083; https://doaj.org/article/ea5103a6bf1a4680a09ea1cd5fdae0b5
Accession Number: edsbas.1D39966E
Database: BASE