Departamento de Cirugía de Trasplantes y Hepatobiliar, Unidad Médica de Alta Especialidad, Hospital de Especialidades 14 Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social.
Departamento de Investigación, Unidad Médica de Alta Especialidad, Hospital de Especialidades 14 Adolfo Ruiz Cortines, IMSS.
Cir Cir. 2022;90(3):359-364. doi: 10.24875/CIRU.20001256.
Multiple models have tried to predict the morbidity and mortality of liver resections (HR). This study aims to determine the efficacy and validity of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) surgical risk calculator in a cohort of patients undergoing HR in Veracruz, Mexico.
Retrospective analysis of patients undergoing HR between 2005 and 2019. To estimate the performance of the calculator, the observed results were compared with the average risk predicted by the calculator, using ROC curve, Brier score and Z test.
67 patients were evaluated, mean age 51.9 years of age, 50.7% female. The majority of resections (56.7%) were for malignancy and 62.1% were partial hepatectomies (up to 3 liver segments). The morbidity was 25.4% and the mortality 4.5%. There was a good prediction in the complications (serious complication: C = 0.725 statistic, Brier score 0.26, p = 0.006 and any statistical complication C = 0.731, Brier score 0.33, p = 0.005) and mortality (C = 0.922 statistic, Brier score 0.005, p = 0.014).
The application of the ACS-NSQIP calculator in patients undergoing HR has good discrimination power and good predictive ability. Prediction of postoperative risks achieves a preoperative planning of the appropriate procedure.
多种模型试图预测肝切除术（HR）的发病率和死亡率。本研究旨在确定美国外科医师学院国家外科质量改进计划（ACS-NSQIP）手术风险计算器在墨西哥韦拉克鲁斯州接受 HR 的患者队列中的疗效和有效性。
回顾性分析 2005 年至 2019 年期间接受 HR 的患者。为了估计计算器的性能，使用 ROC 曲线、Brier 评分和 Z 检验将观察到的结果与计算器预测的平均风险进行比较。
评估了 67 例患者，平均年龄为 51.9 岁，女性占 50.7%。大多数切除术（56.7%）为恶性肿瘤，62.1%为部分肝切除术（最多 3 个肝段）。发病率为 25.4%，死亡率为 4.5%。并发症预测良好（严重并发症：C = 0.725 统计学，Brier 评分 0.26，p = 0.006 和任何统计学并发症 C = 0.731，Brier 评分 0.33，p = 0.005）和死亡率（C = 0.922 统计学，Brier 评分 0.005，p = 0.014）。
ACS-NSQIP 计算器在接受 HR 的患者中的应用具有良好的判别能力和良好的预测能力。术后风险预测可实现术前规划的适当程序。
