PMID- 24802910
OWN - NLM
STAT- MEDLINE
DCOM- 20150625
LR  - 20140912
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Linking)
VI  - 21
IP  - 11
DP  - 2014 Oct
TI  - Nomogram predicting severe adverse events after musculoskeletal tumor surgery: 
      analysis of a national administrative database.
PG  - 3564-71
LID - 10.1245/s10434-014-3760-0 [doi]
AB  - BACKGROUND: There have been no nationwide surveys of postoperative adverse events 
      (AEs) after musculoskeletal tumor surgery focusing on their severity. Therefore, 
      we developed a nomogram to predict severe AEs after musculoskeletal tumor 
      surgery. METHODS: We identified patients in the Diagnosis Procedure Combination 
      database who underwent musculoskeletal tumor surgery during 2007-2012, and 
      defined severe AEs as follows: (i) in-hospital mortality; (ii) postoperative 
      medications including massive transfusion (>/=1,400 mL), catecholamines, gamma-globulin 
      products, protease inhibitors, and medications for disseminated intravascular 
      coagulation; and (iii) postoperative interventions consisting of mechanical 
      ventilation, dialysis support, and cardiac support. Logistic regression models 
      were used to address the occurrence of severe AEs. RESULTS: Of 5,716 patients 
      identified, 613 patients (10.7 %) had severe AEs. Multivariate analyses showed an 
      inverse relationship between body mass index (BMI) and severe AEs (odds ratio 
      1.80 for BMI <18.50; p < 0.001) after adjustment for other significant factors, 
      including sex, age, tumor location, Charlson comorbidity index, type of surgery, 
      and duration of anesthesia. A nomogram and a calibration plot based on these 
      results were well-fitted to predict the probability of severe AEs after 
      musculoskeletal tumor surgery (concordance index 0.781). CONCLUSIONS: We 
      developed a nomogram predicting the probability of severe AEs after 
      musculoskeletal tumor surgery. In addition, we clarified that underweight, but 
      not overweight or obese, status was significantly associated with increased 
      severe AEs after adjusting for patient background characteristics.
FAU - Ogura, Koichi
AU  - Ogura K
AD  - Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, 
      Japan.
FAU - Yasunaga, Hideo
AU  - Yasunaga H
FAU - Horiguchi, Hiromasa
AU  - Horiguchi H
FAU - Fushimi, Kiyohide
AU  - Fushimi K
FAU - Tanaka, Sakae
AU  - Tanaka S
FAU - Kawano, Hirotaka
AU  - Kawano H
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140507
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Databases, Factual
MH  - Female
MH  - Follow-Up Studies
MH  - Hospital Mortality
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Musculoskeletal Diseases/*mortality/*surgery
MH  - Neoplasm Staging
MH  - Neoplasms/*mortality/*surgery
MH  - *Nomograms
MH  - Orthopedic Procedures/*adverse effects
MH  - *Postoperative Complications
MH  - Risk Factors
MH  - Survival Rate
EDAT- 2014/05/08 06:00
MHDA- 2015/06/26 06:00
CRDT- 2014/05/08 06:00
PHST- 2014/02/25 00:00 [received]
PHST- 2014/05/08 06:00 [entrez]
PHST- 2014/05/08 06:00 [pubmed]
PHST- 2015/06/26 06:00 [medline]
AID - 10.1245/s10434-014-3760-0 [doi]
PST - ppublish
SO  - Ann Surg Oncol. 2014 Oct;21(11):3564-71. doi: 10.1245/s10434-014-3760-0. Epub 
      2014 May 7.