title: A simple risk stratification model that predicts 1-year postoperative mortality rate in patients with solid-organ cancer.
abstract: This study aimed to construct a scoring system developed exclusively from the preoperative data that predicts 1-year postoperative mortality in patients with solid cancers. A total of 20,632 patients who had a curative resection for solid-organ cancers between 2007 and 2012 at Chang Gung Memorial Hospital Linkou Medical Center were included in the derivation cohort. Multivariate logistic regression analysis was performed to develop a risk model that predicts 1-year postoperative mortality. Patients were then stratified into four risk groups (low-, intermediate-, high-, and very high-risk) according to the total score (0-43) form mortality risk analysis. An independent cohort of 16,656 patients who underwent curative cancer surgeries at three other hospitals during the same study period (validation cohort) was enrolled to verify the risk model. Age, gender, cancer site, history of previous cancer, tumor stage, Charlson comorbidity index, American Society of Anesthesiologist score, admission type, and Eastern Cooperative Oncology Group performance status were independently predictive of 1-year postoperative mortality. The 1-year postoperative mortality rates were 0.5%, 3.8%, 14.6%, and 33.8%, respectively, among the four risk groups in the derivation cohort (c-statistic, 0.80), compared with 0.9%, 4.2%, 14.6%, and 32.6%, respectively, in the validation cohort (c-statistic, 0.78). The risk stratification model also demonstrated good discrimination of long-term survival outcome of the four-tier risk groups (P < 0.01 for both cohorts). The risk stratification model not only predicts 1-year postoperative mortality but also differentiates long-term survival outcome between the risk groups.
authors: Department of Medical Oncology, Chang Gung Memorial Hospital at LinKou, Taoyuan, Taiwan.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors: Wen-Chi
authors: WC
authors: Chou
authors: Departments of Surgery, Chang Gung Memorial Hospital at LinKou, Taoyuan, Taiwan.|Department of Surgery, School of Medicine, University of Sydney, Sydney, Australia.
authors: Frank
authors: F
authors: Wang
authors: Department of Radiology, Chang Gung Memorial Hospital at Kaoshiung, Kaoshiung, Taiwan.
authors: Yu-Fan
authors: YF
authors: Cheng
authors: Department of Radiation Oncology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan.
authors: Miao-Fen
authors: MF
authors: Chen
authors: Department of Medical Oncology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan.
authors: Chang-Hsien
authors: CH
authors: Lu
authors: Department of Medical Oncology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
authors: Cheng-Hsu
authors: CH
authors: Wang
authors: Department of Medical Oncology, Chang Gung Memorial Hospital at LinKou, Taoyuan, Taiwan.
authors: Yung-Chang
authors: YC
authors: Lin
authors: Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Departments of Surgery, Chang Gung Memorial Hospital at LinKou, Taoyuan, Taiwan.
authors: Ta-Sen
authors: TS
authors: Yeh
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012306:Risk; D013997:Time Factors
keywords: Postoperative mortality; prognostic score; risk model; solid cancer; validation