title: The revised ACPGBI model is a simple and accurate predictor of operative mortality after potentially curative resection of colorectal cancer.
abstract: BACKGROUND
  The Association of Coloproctology of Great Britain and Ireland (ACPGBI) risk-adjustment model for colorectal cancer surgery has been recently revised. The aim of the present study was to compare the performance of the revised ACPGBI model, the original ACPGBI model, P-POSSUM, and CR-POSSUM, in the prediction of operative mortality after resection of colorectal cancer.
  
  
  METHODS
  A total of 423 patients who underwent potentially curative resection of colorectal cancer at a single institution (1997-2007) were included. Data used in the construction of the ACPGBI model was collected prospectively. The models were compared by examining observed to expected (O:E) ratios, the Hosmer-Lemeshow (H-L) goodness-of-fit test, and area under the receiver operator characteristic curve (AUC) analysis.
  
  
  RESULTS
  The 30-day mortality rate was 4%. The performance of the models was as follows: revised ACPGBI model (O:E ratio = 1.05, AUC = 0.73, H-L = 11.02), original ACPGBI model (O:E ratio = 0.58, AUC = 0.76, H-L = 14.23), P-POSSUM (O:E ratio = 0.87, AUC = 0.79, H-L = 10.63), and CR-POSSUM (O:E ratio = 0.63, AUC = 0.84, H-L = 15.84). In subgroup analysis, the revised ACPGBI model performed well in both elective cases (O:E ratio = 1.06) and emergency cases (O:E ratio = 0.91).
  
  
  CONCLUSIONS
  The revised ACPGBI model is simple to construct and accurately predicts operative mortality after potentially curative resection of colorectal cancer.
authors.affiliation: Glasgow University Department of Surgery, Glasgow Royal Infirmary, Glasgow, UK. colinhrichards@hotmail.com
authors.forename: Colin H
authors.initials: CH
authors.lastname: Richards
authors.forename: E Fiona
authors.initials: EF
authors.lastname: Leitch
authors.forename: John H
authors.initials: JH
authors.lastname: Anderson
authors.forename: Ruth F
authors.initials: RF
authors.lastname: McKee
authors.forename: Donald C
authors.initials: DC
authors.lastname: McMillan
authors.forename: Paul G
authors.initials: PG
authors.lastname: Horgan
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D020379:Risk Adjustment; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate