Abstract
Background: Various models have been proposed to predict mortality rates for hospital patients undergoing colorectal cancer surgery. However, none have been developed in Spain using clinical administrative databases and none are based exclusively on the variables available upon admission. Our study aim is to detect factors associated with in-hospital mortality in patients undergoing surgery for colorectal cancer and, on this basis, to generate a predictive mortality score. Methods: A population cohort for analysis was obtained as all hospital admissions for colorectal cancer during the period 2008–2014, according to the Spanish Minimum Basic Data Set. The main measure was actual and expected mortality after the application of the considered mathematical model. A logistic regression model and a mortality score were created, and internal validation was performed. Results: 115,841 hospitalization episodes were studied. Of these, 80% were included in the training set. The variables associated with in-hospital mortality were age (OR: 1.06, 95%CI: 1.05–1.06), urgent admission (OR: 4.68, 95% CI: 4.36–5.02), pulmonary disease (OR: 1.43, 95%CI: 1.28–1.60), stroke (OR: 1.87, 95%CI: 1.53–2.29) and renal insufficiency (OR: 7.26, 95%CI: 6.65–7.94). The level of discrimination (area under the curve) was 0.83. Conclusions: This mortality model is the first to be based on administrative clinical databases and hospitalization episodes. The model achieves a moderate–high level of discrimination.
Highlights
The incidence of colorectal cancer (CRC) is very high, in recent years its prognosis has improved substantially and mortality has decreased, thanks to advances in surgical techniques and cancer therapies, as well as earlier diagnoses and the use of high quality treatment approaches [1,2].Int
Of the 92,768 hospitalization episodes evaluated in the training set (TRS), 60.1% (n = 55,735) were male patients and 77.4% were scheduled admissions
“final model”, is the first predictive model to be developed in Spain exclusively from clinical administrative databases as a means of stimating the risk of postoperative mortality in patients admitted with CRC
Summary
The incidence of colorectal cancer (CRC) is very high, in recent years its prognosis has improved substantially and mortality has decreased, thanks to advances in surgical techniques and cancer therapies, as well as earlier diagnoses and the use of high quality treatment approaches [1,2]. Res. Public Health 2020, 17, 4216; doi:10.3390/ijerph17124216 www.mdpi.com/journal/ijerph. Various models have been proposed to predict mortality rates for hospital patients undergoing colorectal cancer surgery. None have been developed in Spain using clinical administrative databases and none are based exclusively on the variables available upon admission. Our study aim is to detect factors associated with in-hospital mortality in patients undergoing surgery for colorectal cancer and, on this basis, to generate a predictive mortality score
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