年龄校正的查尔森合并症指数与盆腔手术30天发病率
Age-adjusted charlson comorbidity index and 30-day morbidity in pelvic surgeries.
作者信息
Dessai Sampada B, Fasal R, Dipin J, Adarsh D, Balasubramanian Satheesan
机构信息
Department of Surgical Oncology, Malabar Cancer Center, Kannur, Kerala, India.
出版信息
South Asian J Cancer. 2018 Oct-Dec;7(4):240-243. doi: 10.4103/sajc.sajc_241_17.
INTRODUCTION
Charlson comorbidity index (CCI) is a validated tool enabling clinicians for prediction of adverse events posttherapy. In this study, we planned to estimate the predictive value of age-adjusted CCI (ACCI) in assessing the perioperative complication in oncological patients undergoing major pelvic surgeries.
METHODS
This was a single arm, prospective, observational study, in which adult patients with pelvic malignancies undergoing pelvic surgeries were selected. The relationship between the ACCI and Grade 3-5 adverse events were tested using Fisher's test.
RESULTS
The rate of Grade 3-5 adverse event rate was 16.7% (11 patients, = 66). Among the whole cohort, 11 patients (16.7%) had high score on ACCI. The rate of Grade 3-5 adverse events was higher in the cohort of patients with high ACCI score (45.5% vs. 10.9%, = 0.014). The sensitivity, specificity and negative and positive predictive values were 45.5%, 89.1%, 89.1%, and 45.5%, respectively.
CONCLUSION
ACCI can predict for postsurgical adverse events. It has a high negative predictive value for nonoccurrence of adverse events.
引言
查尔森合并症指数（CCI）是一种经过验证的工具，可帮助临床医生预测治疗后的不良事件。在本研究中，我们计划评估年龄调整后的CCI（ACCI）在评估接受大型盆腔手术的肿瘤患者围手术期并发症方面的预测价值。
方法
这是一项单臂、前瞻性观察性研究，选取接受盆腔手术的成年盆腔恶性肿瘤患者。使用Fisher检验来检验ACCI与3-5级不良事件之间的关系。
结果
3-5级不良事件发生率为16.7%（11例患者，n = 66）。在整个队列中，11例患者（16.7%）的ACCI得分较高。ACCI得分高的患者队列中3-5级不良事件发生率更高（45.5%对10.9%，P = 0.014）。敏感性、特异性以及阴性和阳性预测值分别为45.5%、89.1%、89.1%和45.5%。
结论
ACCI可以预测术后不良事件。对于不良事件未发生具有较高的阴性预测价值。
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