Development and Validation of a Multivariable Prediction Model of Peri-operative Mortality in Vascular Surgery: The New Zealand Vascular Surgical Risk Tool (NZRISK-VASC).

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dc.contributor.author Kim, Jee Young
dc.contributor.author Boyle, Luke
dc.contributor.author Khashram, Manar
dc.contributor.author Campbell, Doug
dc.coverage.spatial England
dc.date.accessioned 2021-02-08T22:42:19Z
dc.date.available 2021-02-08T22:42:19Z
dc.date.issued 2021-1-7
dc.identifier.citation European journal of vascular and endovascular surgery: The official journal of the European Society for Vascular Surgery. 07 Jan 2021
dc.identifier.issn 1078-5884
dc.identifier.uri https://hdl.handle.net/2292/54387
dc.description.abstract <h4>Objective</h4>Risk calculators and prediction models are available to assist clinicians and patients with peri-operative decision making to optimise outcomes. In a vascular surgical setting, the majority of these models is based on open AAA repair outcomes, and in general their clinical use is limited. The objective of this study was to develop and validate a simple and accurate vascular surgical risk prediction model.<h4>Methods</h4>A national administrative database was accessed to collect information on all adult patients undergoing vascular surgery between 1 July 2011 and 30 June 2016 in New Zealand. The primary outcomes were mortality at 30 days, one year, and two years. Previously established covariables including American Society of Anaesthesiologists (ASA) physical status score, sex, surgical urgency, cancer status and ethnicity were tested, and other covariables such as smoking status, presence of renal failure, diabetes, anatomical site of operation, structure operated, and type of procedures (open or endovascular) were explored. LASSO regression was used to select variables for inclusion in the model.<h4>Results</h4>A total of 21 597 cases formed the final risk prediction models, with covariables including ASA score, gender, surgical urgency, cancer status, presence of renal failure, diabetes, anatomical site, structure operated, and endovascular procedure. The area under the receiver operating curve (AUROC) for 30 day, one year, and two year mortality using L-min model was 0.869, 0.833, and 0.824, respectively, demonstrating very good discrimination. Calibration with the validation dataset was also excellent, with slopes of 0.971, 1.129, and 1.011, respectively, and McFadden's pseudo-R<sup>2</sup> statistics of 0.250, 0.227, and 0.227, respectively.<h4>Conclusion</h4>A simple and accurate multivariable risk calculator for vascular surgical patients was developed and validated using the New Zealand national dataset, with excellent discrimination and calibration for 30 day, one year, and two year mortality.
dc.format.medium Print-Electronic
dc.language eng
dc.publisher Elsevier BV
dc.relation.ispartofseries European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm
dc.subject Clinical decision making
dc.subject Mortality determinant
dc.subject Operative procedures
dc.subject Prognostic factors
dc.subject Vascular surgical procedure
dc.subject 1102 Cardiorespiratory Medicine and Haematology
dc.subject 1103 Clinical Sciences
dc.title Development and Validation of a Multivariable Prediction Model of Peri-operative Mortality in Vascular Surgery: The New Zealand Vascular Surgical Risk Tool (NZRISK-VASC).
dc.type Journal Article
dc.identifier.doi 10.1016/j.ejvs.2020.12.008
dc.date.updated 2021-01-28T19:29:43Z
dc.rights.holder Copyright: 2020 European Society for Vascular Surgery. Published by Elsevier B.V. en
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/33423913
pubs.publication-status Published
dc.rights.accessrights http://purl.org/eprint/accessRights/RetrictedAccess en
pubs.subtype Journal Article
pubs.elements-id 836494
dc.identifier.eissn 1532-2165
dc.identifier.pii S1078-5884(20)31123-0


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