PMID- 19758690
OWN - NLM
STAT- MEDLINE
DCOM- 20091201
LR  - 20091103
IS  - 1095-6859 (Electronic)
IS  - 0090-8258 (Linking)
VI  - 115
IP  - 3
DP  - 2009 Dec
TI  - Clinical audit in gynecological cancer surgery: development of a risk scoring 
      system to predict adverse events.
PG  - 329-33
LID - 10.1016/j.ygyno.2009.08.004 [doi]
AB  - BACKGROUND: Advanced gynecological surgery undertaken in a specialized 
      gynecologic oncology unit may be associated with significant perioperative 
      morbidity. Validated risk prediction models are available for general surgical 
      specialties but currently not for gynecological cancer surgery. OBJECTIVE: The 
      objective of this study was to evaluate risk factors for adverse events (AEs) of 
      patients treated for suspected or proven gynecological cancer and to develop a 
      clinical risk score (RS) to predict such AEs. METHODS: AEs were prospectively 
      recorded and matched with demographical, clinical and histopathological data on 
      369 patients who had an abdominal or laparoscopic procedure for proven or 
      suspected gynecological cancer at a tertiary gynecological cancer center. 
      Stepwise multiple logistic regression was used to determine the best predictors 
      of AEs. For the risk score (RS), the coefficients from the model were scaled 
      using a factor of 2 and rounded to the nearest integer to derive the risk points. 
      Sum of all the risk points form the RS. RESULTS: Ninety-five patients (25.8%) had 
      at least one AE. Twenty-nine (7.9%) and 77 (20.9%) patients experienced intra- 
      and postoperative AEs respectively with 11 patients (3.0%) experiencing both. The 
      independent predictors for any AE were complexity of the surgical procedure, 
      elevated SGOT (serum glutamic oxaloacetic transaminase, > or /=35 U/L), higher 
      ASA scores and overweight. The risk score can vary from 0 to 14. The risk for 
      developing any AE is described by the formula 100 / (1 + e((3.697 - (RS /2)))). 
      CONCLUSION: RS allows for quantification of the risk for AEs. Risk factors are 
      generally not modifiable with the possible exception of obesity.
FAU - Kondalsamy-Chennakesavan, Srinivas
AU  - Kondalsamy-Chennakesavan S
AD  - School of Medicine, The University of Queensland, Brisbane, Australia. 
      uqskonda@uq.edu.au
FAU - Bouman, Chantal
AU  - Bouman C
FAU - De Jong, Suzanne
AU  - De Jong S
FAU - Sanday, Karen
AU  - Sanday K
FAU - Nicklin, Jim
AU  - Nicklin J
FAU - Land, Russell
AU  - Land R
FAU - Obermair, Andreas
AU  - Obermair A
LA  - eng
PT  - Journal Article
DEP - 20090915
PL  - United States
TA  - Gynecol Oncol
JT  - Gynecologic oncology
JID - 0365304
SB  - IM
CIN - Gynecol Oncol. 2009 Dec;115(3):323-4. PMID: 19883850
MH  - Aged
MH  - Clinical Audit/methods
MH  - Female
MH  - Genital Neoplasms, Female/pathology/*surgery
MH  - Gynecologic Surgical Procedures/*adverse effects/standards
MH  - Humans
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Risk Factors
EDAT- 2009/09/18 06:00
MHDA- 2009/12/16 06:00
CRDT- 2009/09/18 06:00
PHST- 2009/06/12 00:00 [received]
PHST- 2009/08/03 00:00 [revised]
PHST- 2009/08/09 00:00 [accepted]
PHST- 2009/09/18 06:00 [entrez]
PHST- 2009/09/18 06:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
AID - S0090-8258(09)00630-1 [pii]
AID - 10.1016/j.ygyno.2009.08.004 [doi]
PST - ppublish
SO  - Gynecol Oncol. 2009 Dec;115(3):329-33. doi: 10.1016/j.ygyno.2009.08.004. Epub 
      2009 Sep 15.