Scientific article
OA Policy
English

Predicting Risk of Post-Operative Morbidity and Mortality following Gynaecological Oncology Surgery (PROMEGO) : A Global Gynaecological Oncology Surgical Outcomes Collaborative Led Study

CollaboratorsUndurraga, Manuela
Published inCancers, vol. 16, no. 11, 2021
Publication date2024-05-26
First online date2024-05-26
Abstract

The medical complexity of surgical patients is increasing, and surgical risk calculators are crucial in providing high-value, patient-centered surgical care. However, pre-existing models are not validated to accurately predict risk for major gynecological oncology surgeries, and many are not generalizable to low- and middle-income country settings (LMICs). The international GO SOAR database dataset was used to develop a novel predictive surgical risk calculator for post-operative morbidity and mortality following gynecological surgery. Fifteen candidate features readily available pre-operatively across both high-income countries (HICs) and LMICs were selected. Predictive modeling analyses using machine learning methods and linear regression were performed. The area-under-the-receiver-operating characteristic curve (AUROC) was calculated to assess overall discriminatory performance. Neural networks (AUROC 0.94) significantly outperformed other models (p < 0.001) for evaluating the accuracy of prediction across three groups, i.e., minor morbidity (Clavien-Dindo I-II), major morbidity (Clavien-Dindo III-V), and no morbidity. Logistic-regression modeling outperformed the clinically established SORT model in predicting mortality (AUROC 0.66 versus 0.61, p < 0.001). The GO SOAR surgical risk prediction model is the first that is validated for use in patients undergoing gynecological surgery. Accurate surgical risk predictions are vital within the context of major cytoreduction surgery, where surgery and its associated complications can diminish quality-of-life and affect long-term cancer survival. A model that requires readily available pre-operative data, irrespective of resource setting, is crucial to reducing global surgical disparities.

Keywords
  • Machine learning
  • Surgical morbidity
  • Surgical mortality
  • Surgical risk calculator
Funding
  • Grampian Endowment Fund [EA3084]
  • Barts Charity [MGU0461]
Citation (ISO format)
GABA, Faiza et al. Predicting Risk of Post-Operative Morbidity and Mortality following Gynaecological Oncology Surgery (PROMEGO) : A Global Gynaecological Oncology Surgical Outcomes Collaborative Led Study. In: Cancers, 2024, vol. 16, n° 11, p. 2021. doi: 10.3390/cancers16112021
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accessLevelPublic
Identifiers
Additional URL for this publicationhttps://www.mdpi.com/2072-6694/16/11/2021
Journal ISSN2072-6694
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