验证 Cairns 预测模型（CPM）预测腹腔镜胆囊切除术转为开腹胆囊切除术的准确性。
External validation of the Cairns Prediction Model (CPM) to predict conversion from laparoscopic to open cholecystectomy.
机构信息
Cairns Clinical School, College of Medicine and Dentistry, James Cook University, Queensland 4870, Australia.
Cairns Clinical School, College of Medicine and Dentistry, James Cook University, Queensland 4870, Australia; Department of Surgery, Townsville Hospital, Queensland, Australia.
出版信息
Am J Surg. 2018 Nov;216(5):949-954. doi: 10.1016/j.amjsurg.2018.03.016. Epub 2018 Mar 14.
BACKGROUND
Valid and user-friendly prediction models for conversion to open cholecystectomy allow for proper planning prior to surgery. The Cairns Prediction Model (CPM) has been in use clinically in the original study site for the past three years, but has not been tested at other sites.
METHODS
A retrospective, single-centred study collected ultrasonic measurements and clinical variables alongside with conversion status from consecutive patients who underwent laparoscopic cholecystectomy from 2013 to 2016 in The Townsville Hospital, North Queensland, Australia. An area under the curve (AUC) was calculated to externally validate of the CPM.
RESULTS
Conversion was necessary in 43 (4.2%) out of 1035 patients. External validation showed an area under the curve of 0.87 (95% CI 0.82-0.93, p = 1.1 × 10).
CONCLUSIONS
In comparison with most previously published models, which have an AUC of approximately 0.80 or less, the CPM has the highest AUC of all published prediction models both for internal and external validation.
背景
有效的、用户友好的中转开腹手术预测模型可在术前进行适当的规划。 Cairns 预测模型（CPM）在过去三年一直在原始研究地点临床使用，但尚未在其他地点进行测试。
方法
回顾性、单中心研究收集了来自 2013 年至 2016 年期间在澳大利亚昆士兰州汤斯维尔医院接受腹腔镜胆囊切除术的连续患者的超声测量值和临床变量以及中转状态。计算曲线下面积（AUC）以对外验证 CPM。
结果
在 1035 名患者中，有 43 名（4.2%）需要中转。外部验证显示 AUC 为 0.87（95%CI 0.82-0.93，p=1.1×10）。
结论
与大多数以前发表的模型相比，CPM 的 AUC 约为 0.80 或更低，CPM 在内部和外部验证中均具有所有已发表预测模型中最高的 AUC。
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