ACS NSQIP手术风险计算器预测开腹宫颈癌根治术手术风险的价值  

Efficacy of the ACS NSQIP surgical risk calculator in open radical hysterectomy

作　　者：袁盛龙 胡缓缓 贡震 YUAN Shenglong;HU Huanhuan;GONG Zhen(Department of Gynecology,Women′s Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健医院)妇科,南京210004

出　　处：《实用医学杂志》2024年第2期140-145,共6页The Journal of Practical Medicine

基　　金：国家自然科学基金资助项目(编号:81872485);南京市卫生科技发展专项资金资助项目(编号:ZKX21048)。

摘　　要：目的评估美国外科医师学会国家外科质量改进计划(ACS NSQIP)手术风险计算器预测我国的早期宫颈癌患者行开腹宫颈癌根治术手术风险。方法收集2021年1-12月在南京医科大学附属妇产医院(南京市妇幼保健院)妇科行开腹宫颈癌根治术139例患者的临床资料。通过ACS NSQIP手术风险计算器获得预测的术后并发症发生率,并与实际发生率进行比较。采用逻辑回归、C-统计量(C-statistic)、Brier值进行分析。结果ACS NSQIP手术风险计算器所预测的开腹宫颈癌根治术后严重并发症、总体并发症、静脉血栓、再入院和二次手术、切口感染发生率均与实际发生率差异较大;预测的平均住院时间亦与实际住院时间存在显著差异[(3.93±0.42)d vs.(13.11±4.71)d,P<0.001]。结论ACS NSQIP手术风险计算器不能准确预测我国开腹宫颈癌根治术患者的术后并发症及住院时间。ed from medical records and the surgical risk scores were calculated using ACS NSQIP surgical risk calculator.The association between risk scores and actual outcomes were assessed using logistic regression together with the c-statistic(area under ROC)and Brier score.Results The ACSNSQIP calculator did not predict accurately for serious complications,any complications,venous thrombo⁃embolism(VTE),readmission,return operation room and surgical site infection(SSI)compared with actual out⁃comes.There was significantly difference in the predicted and actual length of stay(3.93±0.42 days vs.13.11±4.71 days,P<0.001).Conclusions The ACS NSQIP surgical risk calculator failed to predict the postoperative complications and the length of hospital stay for cervical cancer patients undergoing open radical hysterectomy.

关 键 词：宫颈癌 经腹根治术 术后并发症 手术风险计算器 

分 类 号：R713.4[医药卫生—妇产科学]