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Development and external validation of preoperative clinical prediction models for postoperative outcomes including preoperative aerobic fitness in patients approaching elective colorectal cancer surgery.
Cuijpers, Anne C M; Lubbers, Tim; Dronkers, Jaap J; Heldens, Aniek F J M; Zoethout, Siebrand B; Leistra, Duncan; van Kuijk, Sander M J; van Meeteren, Nico L U; Stassen, Laurents P S; Bongers, Bart C.
Afiliación
  • Cuijpers ACM; Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Surgery, GROW, Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands. Electronic address: a.cuijpers@maastrichtuniversity.nl.
  • Lubbers T; Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Surgery, GROW, Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands. Electronic address: tim.lubbers@mumc.nl.
  • Dronkers JJ; Expertise Centre Healthy Urban Living, Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands. Electronic address: jaap.dronkers@hu.nl.
  • Heldens AFJM; Department of Physical Therapy, Maastricht University Medical Centre, Maastricht, the Netherlands. Electronic address: aniek.heldens@mumc.nl.
  • Zoethout SB; Department of Physical Therapy, Deventer Hospital, Deventer, the Netherlands. Electronic address: s.zoethout@dz.nl.
  • Leistra D; Department of Physical Therapy, Nij Smellinghe Hospital, Drachten, the Netherlands. Electronic address: d.leistra@nijsmellinghe.nl.
  • van Kuijk SMJ; Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, the Netherlands. Electronic address: sander.van.kuijk@mumc.nl.
  • van Meeteren NLU; Top Sector Life Sciences and Health (Health∼Holland), The Hague, the Netherlands; Department of Anesthesiology, Erasmus Medical Centre, Rotterdam, the Netherlands. Electronic address: meeteren@health-holland.com.
  • Stassen LPS; Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Surgery, NUTRIM, Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands. Electronic address: lps.stassen@mumc.nl.
  • Bongers BC; Department of Surgery, NUTRIM, Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands; Department of Nutrition and Movement Sciences, NUTRIM, Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastrich
Eur J Surg Oncol ; 50(6): 108338, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38728861
ABSTRACT

INTRODUCTION:

Preoperative aerobic fitness is associated with postoperative outcomes after elective colorectal cancer (CRC) surgery. This study aimed to develop and externally validate two clinical prediction models incorporating a practical test to assess preoperative aerobic fitness to distinguish between patients with and without an increased risk for 1) postoperative complications and 2) a prolonged time to in-hospital recovery of physical functioning after elective colorectal cancer (CRC) surgery. MATERIALS AND

METHODS:

Models were developed using prospective data from 256 patients and externally validated using prospective data of 291 patients. Postoperative complications were classified according to Clavien-Dindo. The modified Iowa level of assistance scale (mILAS) was used to determine time to postoperative in-hospital physical recovery. Aerobic fitness, age, sex, body mass index, American Society of Anesthesiologists (ASA) classification, neoadjuvant treatment, surgical approach, tumour location, and preoperative haemoglobin level were potential predictors. Areas under the curve (AUC), calibration plots, and Hosmer-Lemeshow tests evaluated predictive performance.

RESULTS:

Aerobic fitness, sex, age, ASA, tumour location, and surgical approach were included in the final models. External validation of the model for complications and postoperative recovery presented moderate to fair discrimination (AUC 0.666 (0.598-0.733) and 0.722 (0.651-0.794), respectively) and good calibration. High sensitivity and high negative predictive values were observed in the lower predicted risk categories (<40 %).

CONCLUSION:

Both models identify patients with and without an increased risk of complications or a prolonged time to in-hospital physical recovery. They might be used for improving patient-tailored preoperative risk assessment and targeted and cost-effective application of prehabilitation interventions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Neoplasias Colorrectales / Aptitud Física / Procedimientos Quirúrgicos Electivos Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Neoplasias Colorrectales / Aptitud Física / Procedimientos Quirúrgicos Electivos Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido