Colorectal preOperative surgical score (CrOSS) for mortality in major colorectal surgery

Kong, Cherng Huei, Guest, Glenn D., Stupart, Douglas A., Faragher, Ian G., Chan, Steven T. F. and Watters, David A. 2015, Colorectal preOperative surgical score (CrOSS) for mortality in major colorectal surgery, ANZ journal of surgery, vol. 85, no. 6, pp. 403-407, doi: 10.1111/ans.13066.

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Title Colorectal preOperative surgical score (CrOSS) for mortality in major colorectal surgery
Author(s) Kong, Cherng Huei
Guest, Glenn D.
Stupart, Douglas A.
Faragher, Ian G.
Chan, Steven T. F.
Watters, David A.ORCID iD for Watters, David A.
Journal name ANZ journal of surgery
Volume number 85
Issue number 6
Start page 403
End page 407
Total pages 5
Publisher Wiley
Place of publication North Melbourne, Vic.
Publication date 2015-06
ISSN 1445-2197
Keyword(s) colon cancer
risk stratification
Science & Technology
Life Sciences & Biomedicine
Summary BACKGROUND: Colorectal surgery carries a significant mortality risk, with reported rates of 1-6% for elective surgery and up to 22% in the emergency setting. Both clinicians and patients will benefit from being able to predict the likelihood of death before surgery. Recently, we have described and validated two risk stratification models for colorectal surgery, the Barwon Health 2012 and Association Française de Chirurgie models. However, these models are not suitable for assessment at patient's bedside. The purpose of this study is to develop a simplified preoperative model capable of predicting mortality following colorectal surgery. METHODS: The new model is termed Colorectal preOperative Surgical Score (CrOSS). The development and internal validation of CrOSS was performed using a prospectively maintained colorectal database. External validation was performed using retrospective data. Univariate and multivariate analyses were performed in model development. Calibration and discrimination were used for model validation. RESULTS: There were 474 and 389 consecutive colorectal surgeries at Geelong Hospital and Western Hospital. Overall mortality rates were 5.16% and 1.03%, respectively. Significant predictors for mortality were as follows: age ≥70, urgent operation, albumin ≤30 g/L and congestive heart failure (receiver operating characteristic (ROC) = 0.870, calibration P-value = 0.937). The predicted risk of mortality was stratified according to the risk profile of 0.39-66.51%. When validated externally, CrOSS predicted mortality accurately (ROC = 0.847, calibration P-value = 0.199). CONCLUSIONS: A robust and simple preoperative model has been created to risk-stratify patients for colorectal surgery. This was successfully validated at another tertiary hospital.
Language eng
DOI 10.1111/ans.13066
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Wiley
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Document type: Journal Article
Collection: School of Medicine
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