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Title: Validity of the CR-POSSUM model in surgery for colorectal cancer in Spain (CCR-CARESS study) and comparison with other models to predict operative mortality.
Authors: Baré, Marisa
Alcantara, Manuel Jesús
Gil, Maria José
Collera, Pablo
Pont, Marina
Escobar, Antonio
Sarasqueta, Cristina
Redondo, Maximino
Briones, Eduardo
Dujovne, Paula
Quintana, Jose Maria
CARESS-CCR Study Group
Keywords: Colorectal cancer;Cr-possum;Operative mortality;Predictive model
metadata.dc.subject.mesh: Adult
Aged, 80 and over
Colorectal Neoplasms
Hospital Mortality
Logistic Models
Middle Aged
Predictive Value of Tests
Prospective Studies
ROC Curve
Reproducibility of Results
Risk Assessment
Issue Date: 29-Jan-2018
Abstract: To validate and recalibrate the CR- POSSUM model and compared its discriminatory capacity with other European models such as POSSUM, P-POSSUM, AFC or IRCS to predict operative mortality in surgery for colorectal cancer. Prospective multicenter cohort study from 22 hospitals in Spain. We included patients undergoing planned or urgent surgery for primary invasive colorectal cancers between June 2010 and December 2012 (N = 2749). Clinical data were gathered through medical chart review. We validated and recalibrated the predictive models using logistic regression techniques. To calculate the discriminatory power of each model, we estimated the areas under the curve - AUC (95% CI). We also assessed the calibration of the models by applying the Hosmer-Lemeshow test. In-hospital mortality was 1.5% and 30-day mortality, 1.7%. In the validation process, the discriminatory power of the CR-POSSUM for predicting in-hospital mortality was 73.6%. However, in the recalibration process, the AUCs improved slightly: the CR-POSSUM reached 75.5% (95% CI: 67.3-83.7). The discriminatory power of the CR-POSSUM for predicting 30-day mortality was 74.2% (95% CI: 67.1-81.2) after recalibration; among the other models the POSSUM had the greatest discriminatory power, with an AUC of 77.0% (95% CI: 68.9-85.2). The Hosmer-Lemeshow test showed good fit for all the recalibrated models. The CR-POSSUM and the other models showed moderate capacity to discriminate the risk of operative mortality in our context, where the actual operative mortality is low. Nevertheless the IRCS might better predict in-hospital mortality, with fewer variables, while the CR-POSSUM could be slightly better for predicting 30-day mortality. Registered at: Identifier: NCT02488161.
metadata.dc.identifier.doi: 10.1186/s12913-018-2839-x
Appears in Collections:Producción 2020

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