Derivation and validation of a preoperative risk model for postoperative mortality (SAMPE model) : an approach to care stratification
dc.contributor.author | Stefani, Luciana Paula Cadore | pt_BR |
dc.contributor.author | Gutierrez, Cláudia de Souza | pt_BR |
dc.contributor.author | Castro, Stela Maris de Jezus | pt_BR |
dc.contributor.author | Zimmer, Rafael Leal | pt_BR |
dc.contributor.author | Diehl, Felipe Polgati | pt_BR |
dc.contributor.author | Meyer, Leonardo Elman | pt_BR |
dc.contributor.author | Caumo, Wolnei | pt_BR |
dc.date.accessioned | 2018-02-16T02:29:25Z | pt_BR |
dc.date.issued | 2017 | pt_BR |
dc.identifier.issn | 1932-6203 | pt_BR |
dc.identifier.uri | http://hdl.handle.net/10183/172571 | pt_BR |
dc.description.abstract | Ascertaining which patients are at highest risk of poor postoperative outcomes could improve care and enhance safety. This study aimed to construct and validate a propensity index for 30-day postoperative mortality. A retrospective cohort study was conducted at Hospital de ClõÂnicas de Porto Alegre, Brazil, over a period of 3 years. A dataset of 13524 patients was used to develop the model and another dataset of 7254 was used to validate it. The primary outcome was 30-day in-hospital mortality. Overall mortality in the development dataset was 2.31% [n = 311; 95% confidence interval: 2.06±2.56%]. Four variables were significantly associated with outcome: age, ASA class, nature of surgery (urgent/emergency vs elective), and surgical severity (major/intermediate/minor). The index with this set of variables to predict mortality in the validation sample (n = 7253) gave an AUROC = 0.9137, 85.2% sensitivity, and 81.7% specificity. This sensitivity cut-off yielded four classes of death probability: class I, <2%; class II, 2±5%; class III, 5±10%; class IV, >10%. Model application showed that, amongst patients in risk class IV, the odds of death were approximately fivefold higher (odds ratio 5.43, 95% confidence interval: 2.82±10.46) in those admitted to intensive care after a period on the regular ward than in those sent to the intensive care unit directly after surgery. The SAMPE (Anaesthesia and Perioperative Medicine Service) model accurately predicted 30-day postoperative mortality. This model allows identification of high-risk patients and could be used as a practical tool for care stratification and rational postoperative allocation of critical care resources. | en |
dc.format.mimetype | application/pdf | pt_BR |
dc.language.iso | eng | pt_BR |
dc.relation.ispartof | PLoS ONE. San Francisco. Vol. 12, no. 10 (Oct. 2017), e0187122, 10 p. | pt_BR |
dc.rights | Open Access | en |
dc.subject | Bioestatística | pt_BR |
dc.subject | HIV | pt_BR |
dc.title | Derivation and validation of a preoperative risk model for postoperative mortality (SAMPE model) : an approach to care stratification | pt_BR |
dc.type | Artigo de periódico | pt_BR |
dc.identifier.nrb | 001053255 | pt_BR |
dc.type.origin | Estrangeiro | pt_BR |
Este item está licenciado na Creative Commons License
-
Artigos de Periódicos (39149)Ciências da Saúde (10550)
-
Artigos de Periódicos (39149)Ciências Exatas e da Terra (5955)