Clinical audit in gynecological cancer surgery: Development of a risk scoring system to predict adverse events

Kondalsamy-Chennakesavan, Srinivas, Bouman, Chantal, De Jong, Suzanne, Sanday, Karen, Nicklin, Jim, Land, Russell and Obermair, Andreas (2009). Clinical audit in gynecological cancer surgery: Development of a risk scoring system to predict adverse events. In: Gynecologic Oncology: Annual Scientific Meeting of the Australian-and-New-Zealand -Gynaecological-Oncology-Group/Australian-Society of Gynaecological Oncology. Annual Scientific Meeting of the Australian and New Zealand Gynaecological Oncology Group/Australian Society of Gynaecological Oncology, Noosa, Australia, (329-333). 2 April 2009. doi:10.1016/j.ygyno.2009.08.004


Author Kondalsamy-Chennakesavan, Srinivas
Bouman, Chantal
De Jong, Suzanne
Sanday, Karen
Nicklin, Jim
Land, Russell
Obermair, Andreas
Title of paper Clinical audit in gynecological cancer surgery: Development of a risk scoring system to predict adverse events
Conference name Annual Scientific Meeting of the Australian and New Zealand Gynaecological Oncology Group/Australian Society of Gynaecological Oncology
Conference location Noosa, Australia
Conference dates 2 April 2009
Proceedings title Gynecologic Oncology: Annual Scientific Meeting of the Australian-and-New-Zealand -Gynaecological-Oncology-Group/Australian-Society of Gynaecological Oncology   Check publisher's open access policy
Journal name Gynecologic Oncology   Check publisher's open access policy
Place of Publication Maryland Heights, MO, United States
Publisher Academic Press
Publication Year 2009
Sub-type Fully published paper
DOI 10.1016/j.ygyno.2009.08.004
ISSN 0090-8258
1095-6859
Volume 115
Issue 3
Start page 329
End page 333
Total pages 4
Language eng
Formatted Abstract/Summary
Background:  Advanced gynecological surgery undertaken in a specialized gynecologic oncology unit may be associated with significant perioperative morbidity. Validated risk prediction models are available for general surgical specialties but currently not for gynecological cancer surgery.

Objective: 
The objective of this study was to evaluate risk factors for adverse events (AEs) of patients treated for suspected or proven gynecological cancer and to develop a clinical risk score (RS) to predict such AEs.

Methods: 
AEs were prospectively recorded and matched with demographical, clinical and histopathological data on 369 patients who had an abdominal or laparoscopic procedure for proven or suspected gynecological cancer at a tertiary gynecological cancer center. Stepwise multiple logistic regression was used to determine the best predictors of AEs. For the risk score (RS), the coefficients from the model were scaled using a factor of 2 and rounded to the nearest integer to derive the risk points. Sum of all the risk points form the RS.

Results: 
Ninety-five patients (25.8%) had at least one AE. Twenty-nine (7.9%) and 77 (20.9%) patients experienced intra- and postoperative AEs respectively with 11 patients (3.0%) experiencing both. The independent predictors for any AE were complexity of the surgical procedure, elevated SGOT (serum glutamic oxaloacetic transaminase, ≥ 35 U/L), higher ASA scores and overweight. The risk score can vary from 0 to 14. The risk for developing any AE is described by the formula 100 / (1 + e(3.697 − (RS /2))).

Conclusion: 
RS allows for quantification of the risk for AEs. Risk factors are generally not modifiable with the possible exception of obesity.
Subjects 1112 Oncology and Carcinogenesis
Keyword Adverse events
Complications
Risk factors
Laparoscopy
Laparotomy
Quality of surgical care
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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Created: Sun, 06 Dec 2009, 00:06:19 EST