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, > or /=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.
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, > or /=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.
Authors: Behrouz Zand; Michael Frumovitz; Matias F Jofre; Alpa M Nick; Ricardo Dos Reis; Mark F Munsell; Haleh Sangi-Haghpeykar; Charles Levenback; Pamela T Soliman; Kathleen M Schmeler; Pedro T Ramirez Journal: Gynecol Oncol Date: 2012-06-02 Impact factor: 5.482
Authors: Stephen B Williams; Yong Shan; Mohamed D Ray-Zack; Hogan K Hudgins; Usama Jazzar; Douglas S Tyler; Stephen J Freedland; Todd A Swanson; Jacques G Baillargeon; Jim C Hu; Sapna Kaul; Ashish M Kamat; John L Gore; Hemalkumar B Mehta Journal: JAMA Surg Date: 2019-08-21 Impact factor: 14.766
Authors: Andreas Obermair; Eva Baxter; Donal J Brennan; Jessica N McAlpine; Jennifer J Muellerer; Frédéric Amant; Mignon D J M van Gent; Robert L Coleman; Shannon N Westin; Melinda S Yates; Camilla Krakstad; Monika Janda Journal: Obstet Gynecol Sci Date: 2020-07-08
Authors: R Iyer; A Gentry-Maharaj; A Nordin; M Burnell; R Liston; R Manchanda; N Das; R Desai; R Gornall; A Beardmore-Gray; J Nevin; K Hillaby; S Leeson; A Linder; A Lopes; D Meechan; T Mould; S Varkey; A Olaitan; B Rufford; A Ryan; S Shanbhag; A Thackeray; N Wood; K Reynolds; U Menon Journal: Br J Cancer Date: 2014-12-23 Impact factor: 7.640