Background: An accurate pre-operative risk assessment could reduce morbidity and mortality for high-risk surgical patients. The aim of the study was to implement and preliminary validate a new score that could predict the occurrence of post-operative complica- tions (PoCs): the Anesthesiological and Surgical Postoperative Risk Assessment (ASPRA) score. Methods: The ASPRA score was created through a literature’s review; a score of 1–3 was given to each identified risk factor, according to its statistical correlation with PoC. ASPRA was retro- spectively applied to a derivation set of 176 surgical patients. A receiver operating characteristic (ROC) analysis evaluated the dis- criminating ability of the score and cutoff value in predicting the occurrence of PoCs, according to the Clavien-Dindo classification of surgical complications. The statistical validation of the score and related cutoff values was prospectively ran within a validation set of 1928 surgical patients. Results: Through ROC analysis, an ASPRA score of 7 was chosen as the cutoff value in the derivation set. In the validation set, 65.3% of patients presented a PoC (Clavien ≥ 1). In this group, ROC analysis showed an area under the curve (AUC) of 0.72, and although poten- tially related to the high rate of complications a high positive predic- tive value of 87.0% has been observed. No significant differences were found in ROC-AUC, sensitivity, specificity, or positive or nega- tive predictive value between the derivation and validation sets (P > 0.05). Conclusion: The new ASPRA score has a high positive predictive value to predict the occurrence of PoCs. Further prospective studies are required to confirm these results.

Implementation and preliminary validation of a new score that predicts post-operative complications / Chelazzi, C; Villa, G; Vignale, I; Falsini, S; Boni, L; De Gaudio, AR. - In: ACTA ANAESTHESIOLOGICA SCANDINAVICA. - ISSN 1399-6576. - ELETTRONICO. - 59:(2015), pp. 609-618. [10.1111/aas.12488]

Implementation and preliminary validation of a new score that predicts post-operative complications

CHELAZZI, COSIMO;VILLA, GIANLUCA;VIGNALE, ILARIA;FALSINI, SILVIA;BONI, LUCA;DE GAUDIO, ANGELO RAFFAELE
2015

Abstract

Background: An accurate pre-operative risk assessment could reduce morbidity and mortality for high-risk surgical patients. The aim of the study was to implement and preliminary validate a new score that could predict the occurrence of post-operative complica- tions (PoCs): the Anesthesiological and Surgical Postoperative Risk Assessment (ASPRA) score. Methods: The ASPRA score was created through a literature’s review; a score of 1–3 was given to each identified risk factor, according to its statistical correlation with PoC. ASPRA was retro- spectively applied to a derivation set of 176 surgical patients. A receiver operating characteristic (ROC) analysis evaluated the dis- criminating ability of the score and cutoff value in predicting the occurrence of PoCs, according to the Clavien-Dindo classification of surgical complications. The statistical validation of the score and related cutoff values was prospectively ran within a validation set of 1928 surgical patients. Results: Through ROC analysis, an ASPRA score of 7 was chosen as the cutoff value in the derivation set. In the validation set, 65.3% of patients presented a PoC (Clavien ≥ 1). In this group, ROC analysis showed an area under the curve (AUC) of 0.72, and although poten- tially related to the high rate of complications a high positive predic- tive value of 87.0% has been observed. No significant differences were found in ROC-AUC, sensitivity, specificity, or positive or nega- tive predictive value between the derivation and validation sets (P > 0.05). Conclusion: The new ASPRA score has a high positive predictive value to predict the occurrence of PoCs. Further prospective studies are required to confirm these results.
2015
59
609
618
Chelazzi, C; Villa, G; Vignale, I; Falsini, S; Boni, L; De Gaudio, AR
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/991407
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