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External Validation of the American College of Surgeons Surgical Risk Calculator in Elderly Patients Undergoing General Surgery Operations. | LitMetric

AI Article Synopsis

  • Preoperative risk assessment for elderly surgical patients is crucial and can be effectively conducted using the American College of Surgeons Surgical Risk Calculator (ACS-SRC), though its applicability to older adults has been under-researched.
  • This study conducted a retrospective analysis of patients over 65 who underwent general surgery in Greece from 2012-2017, evaluating the ACS-SRC's ability to predict post-operative outcomes using statistical metrics.
  • Findings showed that while the ACS-SRC performed well in predicting serious complications and mortality, it struggled with accurately estimating the length of hospital stay, highlighting its strengths and limitations in preoperative care for elderly patients.

Article Abstract

Preoperative risk stratification in the elderly surgical patient is an essential part of contemporary perioperative care and can be done with the use of the American College of Surgeons Surgical Risk Calculator (ACS-SRC). However, data on the generalizability of the ACS-SRC in the elderly is scarce. In this study, we report an external validation of the ACS-RC in a geriatric cohort. A retrospective analysis of a prospectively maintained database was performed including patients aged > 65 who underwent general surgery procedures during 2012−2017 in a Greek academic centre. The predictive ability of the ACS-SRC for post-operative outcomes was tested with the use of Brier scores, discrimination, and calibration metrics. 471 patients were included in the analysis. 30-day postoperative mortality was 3.2%. Overall, Brier scores were lower than cut-off values for almost all outcomes. Discrimination was good for serious complications (c-statistic: 0.816; 95% CI: 0.762−0.869) and death (c-statistic: 0.824; 95% CI: 0.719−0.929). The Hosmer-Lemeshow test showed good calibration for all outcomes examined. Predicted and observed length of stay (LOS) presented significant differences for emergency and for elective cases. The ACS-SRC demonstrated good predictive performance in our sample and can aid preoperative estimation of multiple outcomes except for the prediction of post-operative LOS.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9741190PMC
http://dx.doi.org/10.3390/jcm11237083DOI Listing

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