Objective: To develop a model for predicting postoperative mortality in elderly patients undergoing surgery for colorectal cancer.
Design: Multi-centre study using routinely collected clinical data, assessing patients aged over 80 years, with 30-day operative mortality as the primary end-point.
Data sources: The Association of Coloproctology of Great Britain and Ireland (ACPGBI) database, encompassing 8,077 newly diagnosed colorectal cancer patients undergoing resectional surgery in 79 hospitals between April 2000 to March 2002; The ACPGBI Malignant Bowel Obstruction Study, encompassing 1046 patients with malignant bowel obstruction in 148 hospitals, between April 1998 to March 1999; The Wales-Trent audit, encompassing 3522 newly diagnosed colorectal cancer patients, between July 1992 to June 1993.
Statistical analysis: Logistic regression was used to identify risk factors for in-hospital operative mortality. A multifactorial logistic regression model was developed to adjust for case-mix and to accommodate the variability of outcomes between surgeons. The model was internally validated (re-sampling 50,000 times) and tested using measures of discrimination, calibration and subgroup analysis.
Presented in abstract format at:
American Society of Colon & Rectal Surgeons. Dallas , Texas , USA 2004
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