BACKGROUND: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality. We evaluated the use of latent risk classes to predict the risk of major postoperative complications. METHODS: An observational, retrospective cohort of patients undergoing intra-abdominal general surgery in the 2005 to 2010 American College of Surgeons National Surgical Quality Improvement Program was obtained. Known preoperative comorbidity and risk factor data were entered into LCA models to identify the latent risk classes. Complications were defined as: acute kidney injury, acute respiratory failure, cardiac arrest, deep vein thrombosis, myocardial infarction, organ space infection, pneumonia, postoperative bleeding, pulmonary embolism, sepsis/septic shock, stroke, unplanned reintubation, and/or wound dehiscence. Relative risk regression determined the associations between the latent classes and the 30-day complication risks, with adjustments for the surgical procedure. The area under the curve (AUC) of the receiver operator characteristic curve assessed model performance. RESULTS: LCA fit a 9-class model on 466,177 observations. The composite complication risk was 18.4% but varied from 7.7% in the lowest risk class to 56.7% in the highest risk class. After adjusting for procedure, the latent risk classes were significantly associated with complications, with risk ratios (95% confidence intervals) (compared to the class with the average risk) varying from 0.56 (0.54-0.58) in the lowest risk class to 2.15 (2.11-2.20) in the highest risk class, a 4-fold difference. In models incorporating surgical procedure, latent risk class, and the American Society of Anesthesiologists Physical Status, the AUC for composite complications was 0.76 (0.76-0.76). However, for individual complications, there was heterogeneity in model performance using these variables, with AUCs ranging from 0.70 (0.69-0.71) for pulmonary embolus to 0.90 (0.90-0.90) for acute respiratory failure. CONCLUSIONS: LCA can be used to classify patients undergoing intra-abdominal general surgery based on preoperative risk factors, and the classes are independently associated with postoperative complications. However, model performance is not uniform across individual complications, resulting in variations in the utility of preoperative risk stratification tools depending on the complication evaluated. (C) 2017 International Anesthesia Research Society
http://ift.tt/2wZVPt4
Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com
Αρχειοθήκη ιστολογίου
-
►
2023
(391)
- ► Φεβρουαρίου (200)
- ► Ιανουαρίου (191)
-
►
2022
(2843)
- ► Δεκεμβρίου (161)
- ► Σεπτεμβρίου (219)
- ► Φεβρουαρίου (264)
- ► Ιανουαρίου (280)
-
►
2021
(5625)
- ► Δεκεμβρίου (231)
- ► Σεπτεμβρίου (345)
- ► Φεβρουαρίου (620)
-
►
2020
(2065)
- ► Δεκεμβρίου (535)
- ► Σεπτεμβρίου (222)
- ► Φεβρουαρίου (28)
-
►
2019
(9608)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
- ► Φεβρουαρίου (3791)
- ► Ιανουαρίου (3737)
-
►
2018
(69720)
- ► Δεκεμβρίου (3507)
- ► Σεπτεμβρίου (3851)
- ► Φεβρουαρίου (8116)
- ► Ιανουαρίου (7758)
-
▼
2017
(111579)
- ► Δεκεμβρίου (7718)
- ► Σεπτεμβρίου (7549)
-
▼
Αυγούστου
(7262)
-
▼
Αυγ 15
(159)
- Insulin-Like Growth Factor (IGF) Pathway Targeting...
- Diagnostic performance of a newly developed saliva...
- Pyoderma gangrenosum-like ulcer caused by Helicoba...
- Disappearing subcutaneous papules and nodules: Cha...
- Superficial hemangioma is better treated by topica...
- Ozone generated by air purifier in low concentrati...
- Einfach mal skypen ist nicht erlaubt
- Behandlung von Striae distensae: Viele Versprechen...
- Shampoo mit Selendisulfid
- Viele Muttermale im Kindesalter — Hautkrebsrisiko ...
- Pflegeserie reduziert Unreinheiten tiefenwirksam u...
- Fraktionierte Laser
- Die neue Dimension der fraktionalen RF
- Einmalspritzen zur Behandlung mit Botulinumtoxin T...
- Sonne, Haut und die Dermatologie
- Inhaltsverzeichnis
- Varikose: Schaum-Sklerotherapie statt OP
- Hyaluronsäurefiller: DACH-Guideline für sicheres A...
- Ultraschall-Lifting statt Skalpell
- Wie Spielfilme ein Vorurteil verstärken
- Haben Wundinfektionen im Sommer Hochsaison?
- Goldene Regeln zum Umgang mit Hyaluronsäurefillern
- Laserbehandlung der Onychomykose
- Der Begriff der Gleichwertigkeit
- Die Bedürfnisse des Patienten in den Vordergrund s...
- Die Haut als Spiegel der Seele
- HAPIFED: a Healthy APproach to weIght management a...
- Efficacy of fractional lasers in treating alopecia...
- Immunological Reactivity Using Monoclonal and Poly...
- Immunological Reactivity Using Monoclonal and Poly...
- Incidence of Discomfort During Pure-Tone Audiometr...
- Key Word Signing Usage of Adults With Intellectual...
- Tutorial: Speech Assessment for Multilingual Child...
- Measuring Explicit Word Learning of Preschool Chil...
- Case History Risk Factors for Specific Language Im...
- Language Sampling With Adolescents: Building a Nor...
- Teaching Transnasal Endoscopy to Graduate Students...
- Reporting of Socioeconomic Status in Pediatric Lan...
- A Collaborative Model for Return to Academics Afte...
- Speech-Language Pathologists' Use of Intelligibili...
- Variability of the Pressure Measurements Exerted b...
- Language Samples From Children Who Use Speech-Gene...
- Typical Toddlers' Participation in “Just-in-Time” ...
- Clinically Available Assessment Measures for Lingu...
- Validation of the Intelligibility in Context Scale...
- A Systematic Review of Speech Assessments for Chil...
- Discourse Characteristics in Aphasia Beyond the We...
- Effect of Vitamin D Deficiency on Voice
- Modeling Alphabet Skills as Instructive Feedback W...
- A Mindfulness Practice for Communication Sciences ...
- Assessing the Believability of Standardized Patien...
- SKELETAL MATERIAL FROM THE CEMETERY OF THE 19th CE...
- SLHS MA students receive awards from the American ...
- Very Urgent Carotid Endarterectomy is Associated w...
- Individual Differences in Heparin Sensitivity and ...
- Reconstruction of the femoro-ilio-caval outflow by...
- Outcomes of Pharmacomechanical Catheter-directed T...
- Patency and Clinical Outcome After Stent Placement...
- Selected Abstracts from the August Issue of the Jo...
- Amputation Rates, Mortality, and Pre-operative Com...
- The Impact of Compliance with Imaging Follow-up on...
- Renal complications after EVAR with suprarenal ver...
- Aorta Related and All-cause Mortality in Patients ...
- Editorial Board
- Contents
- Forthcoming Events
- Commentary on “A Pilot Study of Femoropopliteal Ar...
- Long Non-coding RNA–mRNA Correlation Analysis Reve...
- Mid-term Results of Chimney and Periscope Grafts i...
- One year on: Test your knowledge from the previous...
- Commentary on “Outcomes of Self Expanding Polytetr...
- Abstracts from Issue 35 of EJVES Short Reports
- EJVES vol. 54, issue 2 (August 2017) - Spanish Tra...
- Preliminary audiologic and peri-operative outcomes...
- DNA degrades during storage in formalin-fixed and ...
- Dust emission and dispersion from mineral storage ...
- Strengthening the Disaster Resilience of the Acade...
- Screening for Thyroid Cancer: A Systematic Evidenc...
- Ensuring innovation in diagnostics for bacterial i...
- Targeting innovation in antibiotic drug discovery ...
- The Chemistry of Microbiomes: Proceedings of a Sem...
- Principles and Practices for a Federal Statistical...
- An occult ectopic parathyroid adenoma in a pediatr...
- Influence of topical iodine-containing antiseptics...
- Association of obesity and health related quality ...
- Effect of step-feeding on the performance of lab-s...
- Quality of Life Related to Different Treatment Pro...
- Quality of Life Related to Different Treatment Pro...
- Bond strength of etch-and-rinse and self-etch adhe...
- A two-stage predictive model to simultaneous contr...
- Quality and readability of English-language intern...
- A Recurrent Episode of Dermatomyositis Associated ...
- Risk-adapted robotic stereotactic body radiation t...
- Re-expression of pro-fibrotic, embryonic preserved...
- Successful intravenous thrombolysis for ischemic s...
- Oral manifestations, dental management, and a rare...
- A Case of Immediate Hypersensitivity Reaction to M...
- Evaluating Critical Brain Radiation Doses in the T...
- Comparative Evaluation of Magnetic Resonance-Guide...
- Etiologies and management of cutaneous flushing
-
▼
Αυγ 15
(159)
- ► Φεβρουαρίου (10753)
- ► Ιανουαρίου (10529)
-
►
2016
(16402)
- ► Δεκεμβρίου (7478)
- ► Φεβρουαρίου (900)
- ► Ιανουαρίου (1250)
! # Ola via Alexandros G.Sfakianakis on Inoreader
Η λίστα ιστολογίων μου
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Αρχειοθήκη ιστολογίου
-
►
2023
(391)
- ► Φεβρουαρίου (200)
- ► Ιανουαρίου (191)
-
►
2022
(2843)
- ► Δεκεμβρίου (161)
- ► Σεπτεμβρίου (219)
- ► Φεβρουαρίου (264)
- ► Ιανουαρίου (280)
-
►
2021
(5625)
- ► Δεκεμβρίου (231)
- ► Σεπτεμβρίου (345)
- ► Φεβρουαρίου (620)
-
►
2020
(2065)
- ► Δεκεμβρίου (535)
- ► Σεπτεμβρίου (222)
- ► Φεβρουαρίου (28)
-
►
2019
(9608)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
- ► Φεβρουαρίου (3791)
- ► Ιανουαρίου (3737)
-
►
2018
(69720)
- ► Δεκεμβρίου (3507)
- ► Σεπτεμβρίου (3851)
- ► Φεβρουαρίου (8116)
- ► Ιανουαρίου (7758)
-
▼
2017
(111579)
- ► Δεκεμβρίου (7718)
- ► Σεπτεμβρίου (7549)
-
▼
Αυγούστου
(7262)
-
▼
Αυγ 15
(159)
- Insulin-Like Growth Factor (IGF) Pathway Targeting...
- Diagnostic performance of a newly developed saliva...
- Pyoderma gangrenosum-like ulcer caused by Helicoba...
- Disappearing subcutaneous papules and nodules: Cha...
- Superficial hemangioma is better treated by topica...
- Ozone generated by air purifier in low concentrati...
- Einfach mal skypen ist nicht erlaubt
- Behandlung von Striae distensae: Viele Versprechen...
- Shampoo mit Selendisulfid
- Viele Muttermale im Kindesalter — Hautkrebsrisiko ...
- Pflegeserie reduziert Unreinheiten tiefenwirksam u...
- Fraktionierte Laser
- Die neue Dimension der fraktionalen RF
- Einmalspritzen zur Behandlung mit Botulinumtoxin T...
- Sonne, Haut und die Dermatologie
- Inhaltsverzeichnis
- Varikose: Schaum-Sklerotherapie statt OP
- Hyaluronsäurefiller: DACH-Guideline für sicheres A...
- Ultraschall-Lifting statt Skalpell
- Wie Spielfilme ein Vorurteil verstärken
- Haben Wundinfektionen im Sommer Hochsaison?
- Goldene Regeln zum Umgang mit Hyaluronsäurefillern
- Laserbehandlung der Onychomykose
- Der Begriff der Gleichwertigkeit
- Die Bedürfnisse des Patienten in den Vordergrund s...
- Die Haut als Spiegel der Seele
- HAPIFED: a Healthy APproach to weIght management a...
- Efficacy of fractional lasers in treating alopecia...
- Immunological Reactivity Using Monoclonal and Poly...
- Immunological Reactivity Using Monoclonal and Poly...
- Incidence of Discomfort During Pure-Tone Audiometr...
- Key Word Signing Usage of Adults With Intellectual...
- Tutorial: Speech Assessment for Multilingual Child...
- Measuring Explicit Word Learning of Preschool Chil...
- Case History Risk Factors for Specific Language Im...
- Language Sampling With Adolescents: Building a Nor...
- Teaching Transnasal Endoscopy to Graduate Students...
- Reporting of Socioeconomic Status in Pediatric Lan...
- A Collaborative Model for Return to Academics Afte...
- Speech-Language Pathologists' Use of Intelligibili...
- Variability of the Pressure Measurements Exerted b...
- Language Samples From Children Who Use Speech-Gene...
- Typical Toddlers' Participation in “Just-in-Time” ...
- Clinically Available Assessment Measures for Lingu...
- Validation of the Intelligibility in Context Scale...
- A Systematic Review of Speech Assessments for Chil...
- Discourse Characteristics in Aphasia Beyond the We...
- Effect of Vitamin D Deficiency on Voice
- Modeling Alphabet Skills as Instructive Feedback W...
- A Mindfulness Practice for Communication Sciences ...
- Assessing the Believability of Standardized Patien...
- SKELETAL MATERIAL FROM THE CEMETERY OF THE 19th CE...
- SLHS MA students receive awards from the American ...
- Very Urgent Carotid Endarterectomy is Associated w...
- Individual Differences in Heparin Sensitivity and ...
- Reconstruction of the femoro-ilio-caval outflow by...
- Outcomes of Pharmacomechanical Catheter-directed T...
- Patency and Clinical Outcome After Stent Placement...
- Selected Abstracts from the August Issue of the Jo...
- Amputation Rates, Mortality, and Pre-operative Com...
- The Impact of Compliance with Imaging Follow-up on...
- Renal complications after EVAR with suprarenal ver...
- Aorta Related and All-cause Mortality in Patients ...
- Editorial Board
- Contents
- Forthcoming Events
- Commentary on “A Pilot Study of Femoropopliteal Ar...
- Long Non-coding RNA–mRNA Correlation Analysis Reve...
- Mid-term Results of Chimney and Periscope Grafts i...
- One year on: Test your knowledge from the previous...
- Commentary on “Outcomes of Self Expanding Polytetr...
- Abstracts from Issue 35 of EJVES Short Reports
- EJVES vol. 54, issue 2 (August 2017) - Spanish Tra...
- Preliminary audiologic and peri-operative outcomes...
- DNA degrades during storage in formalin-fixed and ...
- Dust emission and dispersion from mineral storage ...
- Strengthening the Disaster Resilience of the Acade...
- Screening for Thyroid Cancer: A Systematic Evidenc...
- Ensuring innovation in diagnostics for bacterial i...
- Targeting innovation in antibiotic drug discovery ...
- The Chemistry of Microbiomes: Proceedings of a Sem...
- Principles and Practices for a Federal Statistical...
- An occult ectopic parathyroid adenoma in a pediatr...
- Influence of topical iodine-containing antiseptics...
- Association of obesity and health related quality ...
- Effect of step-feeding on the performance of lab-s...
- Quality of Life Related to Different Treatment Pro...
- Quality of Life Related to Different Treatment Pro...
- Bond strength of etch-and-rinse and self-etch adhe...
- A two-stage predictive model to simultaneous contr...
- Quality and readability of English-language intern...
- A Recurrent Episode of Dermatomyositis Associated ...
- Risk-adapted robotic stereotactic body radiation t...
- Re-expression of pro-fibrotic, embryonic preserved...
- Successful intravenous thrombolysis for ischemic s...
- Oral manifestations, dental management, and a rare...
- A Case of Immediate Hypersensitivity Reaction to M...
- Evaluating Critical Brain Radiation Doses in the T...
- Comparative Evaluation of Magnetic Resonance-Guide...
- Etiologies and management of cutaneous flushing
-
▼
Αυγ 15
(159)
- ► Φεβρουαρίου (10753)
- ► Ιανουαρίου (10529)
-
►
2016
(16402)
- ► Δεκεμβρίου (7478)
- ► Φεβρουαρίου (900)
- ► Ιανουαρίου (1250)
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου