Department of Surgery, Audie Murphy VA Hospital, South Texas Veterans Healthcare System, USA.
Department of Vascular and Endovascular Surgery, UT Health San Antonio, San Antonio, TX, 78229, USA.
Am J Surg. 2022 Jun;223(6):1212-1216. doi: 10.1016/j.amjsurg.2021.12.008. Epub 2021 Dec 17.
To evaluate the accuracy of multiple risk calculators for 30-day mortality on patients undergoing major lower extremity amputation.
The actual 30-day mortality at a single Veterans Affairs institution was compared to the predicted outcome from the following risk calculators: ACS-NSQIP, VASQIP, amputation scoring tool (AST), and POTTER elective.
The overall calculated 30-day mortality was similar to the actual mortality with the VASQIP and POTTER elective risk calculators, while the NSQIP and AST over-estimated the 30-day mortality. The predictive accuracy of the POTTER and NSQIP risk calculators were moderate (AUC >0.7), and fair for the VASQIP and AST.
Risk assessment tools can provide adjunctive data on predicted 30-day mortality in patients undergoing major lower extremity amputation. In our study, there were differences in predictability of the risk calculators for lower extremity amputation that should be considered when utilizing a risk assessment tool to improve physician-patient shared decision-making.
评估多种风险计算器在预测接受大下肢截肢患者 30 天死亡率方面的准确性。
将单一退伍军人事务机构的实际 30 天死亡率与以下风险计算器的预测结果进行比较：ACS-NSQIP、VASQIP、截肢评分工具 (AST) 和 POTTER 择期。
VASQIP 和 POTTER 择期风险计算器的总体计算 30 天死亡率与实际死亡率相似，而 NSQIP 和 AST 高估了 30 天死亡率。POTTER 和 NSQIP 风险计算器的预测准确性为中度（AUC>0.7），VASQIP 和 AST 为适度。
风险评估工具可以为接受大下肢截肢的患者提供预测 30 天死亡率的辅助数据。在我们的研究中，下肢截肢风险计算器的预测能力存在差异，在使用风险评估工具来改善医患共同决策时应考虑这些差异。
