Background: Operative mortality risk models for adults with congenital heart disease (ACHD) undergoing cardiac operations are essential, given the growing population of these patients, yet they are currently unavailable. Existing adult Society of Thoracic Surgeons (STS) models exclude congenital procedures, whereas existing congenital models exclude operations for acquired disease. We aimed to develop an STS mortality risk model for ACHD patients undergoing cardiac operations.
Methods: Leveraging a comprehensive list of diagnostic and procedure codes, ACHD patients who underwent cardiac operations were identified from the STS Adult Cardiac Surgery Database (versions: v2.73, v2.81, and v2.9) between 2011 and 2019. The model was developed and validated in the ACHD population using a 60/40 development/validation split. Univariate analyses and clinical expertise informed the addition of ACHD-relevant procedure and diagnosis variables to existing STS adult risk model variables. Model performance was assessed overall and in 38 subgroups based on patient demographics, procedures, and diagnoses.
Results: Forty-seven procedure and diagnosis variables relevant to ACHD were added to existing STS adult risk model variables. The derived ACHD model for operative mortality was well calibrated within demographic, procedural, and diagnosis subgroups and the overall ACHD population, and discrimination in the validation cohort was excellent (C statistic, 0.815) compared with the model using only existing STS adult risk model variables (C statistic, 0.79; P < .0001).
Conclusions: A novel, high-performing STS ACHD mortality risk model has been developed on the basis of contemporary patient data. The ACHD risk model represents an important expansion of the STS portfolio. Implementation with an online risk calculator is planned.
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http://dx.doi.org/10.1016/j.athoracsur.2023.01.015 | DOI Listing |
Am J Cancer Res
December 2024
Department of Ultrasound, The Second People's Hospital, Fujian University of Traditional Chinese Medicine Fuzhou 350003, Fujian, China.
Background: Ultra-low rectal endoscopic submucosal dissection (ESD) presents technical challenges due to anatomical features. The objective of this research was to determine the risk factors linked to unsuccessful curative resections and to create a nomogram predictive model to assess the likelihood of encountering technical challenges.
Methods: Patients with ultra-low rectal tumors received ESD form June 2017 to December 2022 were retrospectively enrolled.
Am J Cancer Res
December 2024
Department of General Surgery, Liaoning University of Traditional Chinese Medicine Affiliated Hospital Shenyang 110032, Liaoning, China.
The involvement of axillary lymph nodes (ALNs) is a critical prognostic factor affecting patient management and outcomes in breast cancer (BC). This study aims to comprehensively analyze the clinical data of BC patients, evaluate ultrasonic signs of ALNs, and explore the implications of a prediction model for ALN metastasis (ALNM) in early-stage BC patients based on ultrasonic features and clinical data. This study retrospectively analyzed ultrasonic features and clinical data from 216 patients diagnosed with unilateral invasive BC.
View Article and Find Full Text PDFAm J Cancer Res
December 2024
Department of Critical Care Medicine, South China Hospital of Shenzhen University Shenzhen 518100, Guangdong, PR China.
This study investigated the predictive value of combining peripheral blood indicators with procalcitonin clearance rate (PCTc) to assess mortality risk in cancer patients with sepsis, aiming to develop a more sensitive and specific clinical tool. A retrospective analysis was conducted on 393 cancer patients with sepsis admitted to South China Hospital of Shenzhen University from January 2019 to January 2024. Collected data included clinical demographics, laboratory indicators such as white blood cell count, neutrophil count (NEUT), platelet count (PLT), lymphocyte count (LYC), C-reactive protein, procalcitonin (PCT), alanine aminotransferase, and the ratio of arterial oxygen partial pressure to inspired oxygen fraction, as well as functional scores like Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment.
View Article and Find Full Text PDFAm J Cancer Res
December 2024
Department of Reproductive Medicine, The First Affiliated Hospital, Jinan University Guangzhou 510000, Guangdong, China.
This study aims to construct and optimize risk prediction models for lymph node metastasis (LNM) in endometrial carcinoma (EC) patients, thus improving the identification of patients at high risk of LNM and further providing accurate support for clinical decision-making. This retrospective analysis included 541 cases of EC treated at The First Affiliated Hospital, Jinan University between January 2017 and January 2022. Various clinical and pathological variables were incorporated, including age, body mass index (BMI), pathological grading, myometrial invasion, lymphovascular space invasion (LVSI), estrogen receptor (ER) and progesterone receptor (PR) levels, and tumor size.
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