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Can the ACS-NSQIP surgical risk calculator predict postoperative complications in patients undergoing sacral tumor resection for chordoma?

ACS-NSQIP手术风险计算器能否预测骶骨肿瘤切除脊索瘤患者的术后并发症?

  • 影响因子:2.88
  • DOI:10.1002/jso.25865
  • 作者列表:"Houdek MT","Hevesi M","Griffin AM","Yaszemski MJ","Sim FH","Ferguson PC","Rose PS","Wunder JS
  • 发表时间:2020-05-01
Abstract

BACKGROUND AND OBJECTIVES:The ACS-NSQIP surgical risk calculator is an online tool that estimates the risk of postoperative complications. Sacrectomies for chordoma are associated with a high rate of complications. This study was to determine if the ACS-NSQIP calculator can predict postoperative complications following sacrectomy. METHODS:Sixty-five (42 male, 23 female) patients who underwent sacrectomy were analyzed using the Current Procedural Terminology (CPT) codes: 49215 (excision of presacral/sacral tumor), 63001 (laminectomy of sacral vertebrae), 63728 (laminectomy for biopsy/excision of sacral neoplasm) and 63307 (sacral vertebral corpectomy for intraspinal lesion). The predicted rates of complications were compared to the observed rates. RESULTS:Complications were noted in 44 (68%) patients. Of the risk factors available to input to the ACS-NSQIP calculator, tobacco use (OR, 20.4; P < .001) was predictive of complications. The predicted risk of complications based off the CPT codes were: 49215 (16%); 63011 (6%); 63278 (11%) and 63307 (15%). Based on ROC curves, the use of the ACS-NSQIP score were poor predictors of complications (49215, AUC 0.65); (63011, AUC 0.66); (63307, AUC 0.67); (63278, AUC 0.64). CONCLUSION:The ACS-NSQIP calculator was a poor predictor of complications and was marginally better than a coin flip in its ability to predict complications following sacrectomy for chordoma.

摘要

背景和目的: ACS-NSQIP手术风险计算器是一个在线工具,用于估计术后并发症的风险。脊索瘤的骶骨切除术与高并发症发生率相关。本研究旨在确定ACS-NSQIP计算器能否预测骶骨切除术后的术后并发症。 方法: 65 例 (42 例男性,23 例女性) 接受骶骨切除术的患者采用现行的手术术语 (CPT) 编码: 49215 (骶前/骶骨肿瘤切除术) 进行分析,63001 (椎板切除骶椎),63728 (椎板切除活检/切除骶骨肿瘤) 和 63307 (骶椎椎体切除椎管内病变)。将预测的并发症发生率与观察到的发生率进行比较。 结果: 44 例 (68%) 患者出现并发症。在可输入ACS-NSQIP计算器的危险因素中,烟草使用 (OR,20.4; P <.001) 是并发症的预测因素。基于CPT编码预测的并发症风险分别为: 49215 (16%); 63011 (6% ); 63278 (11%) 和 63307 (15%)。根据ROC曲线,使用ACS-NSQIP评分是并发症的不良预测因子 (49215,AUC 0.65); (63011,AUC 0.66); (63307,AUC 0.67); (63278,AUC 0.64)。 结论: ACS-NSQIP计算器是并发症的不良预测因子,在预测脊索瘤骶骨切除术后并发症的能力方面略优于硬币翻转。

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影响因子:2.12
发表时间:2020-03-01
DOI:10.1259/bjr.20180883
作者列表:["Tran S","Puric E","Walser M","Poel R","Datta NR","Heuberger J","Pica A","Marder D","Lomax N","Bolsi A","Morach P","Bachtiary B","Seddon BM","Schneider R","Bodis S","Weber DC"]

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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

METHODS:BACKGROUND:National guidelines recommend screening and treatment for cancer-related bone disease and continued monitoring of bone-modifying agents. It is unclear whether a standardized screening tool is utilized to identify eligible patients and ensure appropriate supportive care is implemented. The purpose of this study was to evaluate current prescribing practices and optimize management of bone-modifying agents. METHODS:A retrospective chart review was performed to identify patients who received hormone deprivation therapy or had bone metastases through Hematology/Oncology or Urology clinics from 1 November 2016 to 31 October 2017. The primary endpoints of this study were the incidence of completed baseline dual-energy X-ray absorptiometry (DEXA) scan for patients on hormone deprivation therapy and percent of patients started on a bone-modifying agent for the prevention of skeletal-related events secondary to bone metastasis. Secondary endpoints included percent of patients with dental examinations prior to initiation, adequate calcium and vitamin D supplementation, incidence of osteonecrosis of the jaw or flu-like symptoms and education, and percent of bisphosphonate doses appropriately adjusted based on renal function. RESULTS:A total of 375 patients were assessed for baseline DEXA scans and bone-modifying therapy. Of the 226 patients on hormone deprivation therapy, 111 (49%) patients were appropriately screened with a DEXA scan prior to initiation of hormone deprivation therapy. Among the 149 patients with bone metastases, only 94 (63.1%) patients were started on a bone-modifying agent. CONCLUSIONS:Opportunities have been identified to optimize management of patients with cancer-related bone disease. Implementation of standardized tools may increase the rate of appropriate screening and initiation of bone-modifying therapy when warranted.

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影响因子:2.83
发表时间:2020-01-01
DOI:10.1007/s00520-019-04843-9
作者列表:["Dohzono S","Sasaoka R","Takamatsu K","Hoshino M","Nakamura H"]

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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