The accuracy of pre-operative (P)-POSSUM scoring and cardiopulmonary exercise testing in predicting morbidity and mortality after pancreatic and liver surgery: A systematic review

Dutton, John; Zardab, Mohamed; Braal, V.J.F. De; Hariharan, Deepak; MacDonald, Neil; Hallworth, S.; Hutchins, Robert; Bhattacharya, Satya; Abraham, Ajit; Kocher, Hemant M.; Yip, Vincent

doi:10.1016/j.amsu.2020.12.016

Cited by 7 publications

(4 citation statements)

References 39 publications

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“…showed V̇E/V̇CO 2 predicted right ventricle dysfunction, early mortality, and rehabilitation requirement following left ventricular assist device implantation 6 . V̇E/V̇CO 2 also predicted adverse postoperative outcomes following lung resection and intra‐abdominal surgery 7,8 . Our study is the first to demonstrate that V̇E/V̇CO 2 predicts early outcomes following heart transplant.…”

Section: Discussionmentioning

confidence: 55%

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Ventilatory efficiency measured during sub‐maximal cardiopulmonary exercise testing predicts postoperative outcomes following heart transplantation

Jayasimhan¹,

Welch

Ellyett

et al. 2023

Clinical Transplantation

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Cardiopulmonary exercise testing is commonly used to evaluate patients for heart transplantation. We assessed the utility of ventilatory efficiency (VE/VCO2) to predict perioperative outcomes following heart transplantation. We retrospectively reviewed all patients undergoing cardiopulmonary exercise testing prior to heart transplantation at our center. Spearman's coefficient showed a correlation between VE/VCO2 and ICU free days in the first 30‐days post‐transplant (R = –.37, p < .01). A VE/VCO2 cut‐off >35 was associated with significantly lower median ICU‐free days (23.0 vs. 27 days; p < .01) and a higher likelihood of postoperative morbidity (OR = 5.64, 95% CI = 1.75–18.16; p < .01). Multiple regression analysis controlling for peak oxygen consumption and right heart catheter parameters showed VE/VCO2 >35 is independently associated with lower ICU‐free days (p < .01) and postoperative morbidity (p = .02). Peak oxygen consumption <15 mL/min/kg was not associated with higher ICU or hospital‐free days. VE/VCO2 >35 independently predicts early postoperative morbidity in patients undergoing heart transplantation.

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Section: Discussionmentioning

confidence: 55%

“…6 V Ė/V ĊO 2 also predicted adverse postoperative outcomes following lung resection and intraabdominal surgery. 7,8 Our study is the first to demonstrate that V Ė/V ĊO 2 predicts early outcomes following heart transplant.…”

Section: Discussionmentioning

confidence: 77%

Ventilatory efficiency measured during sub‐maximal cardiopulmonary exercise testing predicts postoperative outcomes following heart transplantation

Jayasimhan¹,

Welch

Ellyett

et al. 2023

Clinical Transplantation

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“…[8] There are various scores like (P)POSSUM available to predict postoperative outcomes. [9] However, their accuracies vary according to various centres. One The copyright holder for this preprint this version posted July 6, 2023. ; https://doi.org/10.1101/2023.07.05.23292033 doi: medRxiv preprint of the benefits of supervised machine learning models is that they can be trained as per our data and can be used to predict outcomes, based on local factors, patients' profiles etc.…”

Section: Valuementioning

confidence: 99%

Use of supervised machine learning algorithms in predicting postoperative mortality in gastrointestinal and HPB surgeries

Vasavada

2023

Preprint

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Aim of the study: This study aims to evaluate supervised machine learning algorithms in predicting 90 days post-operative mortality in gastrointestinal and HPB surgeries and comparing them with standard logistic regression methods. Methods: We evaluated various supervised machine learning classification algorithms like gradient boosting, K-nearest neighbours, random forest, and support vector machines with standard logistic regression methods. We used accuracy and the Receiver operating curve to compare the methods. 60% of the data were used for training, 20% for validation and 20% for testing. We used JASP 0.16.04 by the University of Amsterdam to run machine learning algorithms and statistical analysis. Results: We used data from 504 patients who have undergone gastrointestinal and hepatopancreatic biliary surgery between April 2016 and March 2023. We analyzed algorithms for predicting 90 days post-operative mortality based on features like Major surgeries, Surgeries for malignancies, age, CDC grade of surgeries, Intraoperative hypotension, Open vs Laparoscopic surgeries, ASA grade, Emergency surgeries, Operative time, Intraoperative blood product used, colorectal surgeries, small intestinal surgeries, HPB surgeries, upper gastrointestinal surgeries and hernia. Test accuracies were 96% for gradient boosting, 90 % for K-nearest neighbours, 96% for the random forest, 94% for support vector and Areas under the ROC curve were 0.802 for gradient boosting, 0.489 for K-nearest neighbours, 0.934 for random forest and 0.5 for support vector algorithms. Accuracy and Area under the ROC curve with standard logistic regression method were 94% and 0.757. Features of importance in decreasing order were ASA, operative times, blood products, small bowel surgeries and Age. Conclusion: Supervised machine learning algorithms particularly gradient boosting and random forest predicted 90 days post-operative mortality more accurately than logistic regression and such models can be part of the preoperative evaluation in gastrointestinal and HPB surgeries.

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“…Risk assessment for non-cardiac surgery Оценка риска при некардиальных операциях шкала (P)-POSSUM в гепатопанкреатобилиарной хирургии, хотя они и уступают результатам, полученным при кардиопульмональном тесте [29].…”

Section: новые подходы/алгоритмы оценки кардиального рискаunclassified

Assessment and Correction of the Cardiac Complications Risk in Non-cardiac Operations – What's New?

Sumin

2022

Racionalʹnaâ farmakoterapiâ v kardiologii

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Cardiovascular complications after non-cardiac surgery are the leading cause of 30-day mortality. The need for surgical interventions is approximately 5,000 procedures per 100,000 population, according to experts, the risks of non-cardiac surgical interventions are markedly higher in the elderly. It should be borne in mind that the aging of the population and the increased possibilities of medicine inevitably lead to an increase in surgical interventions in older people. Recent years have been characterized by the appearance of national and international guidelines with various algorithms for assessing and correcting cardiac risk, as well as publications on the validation of these algorithms. The purpose of this review was to provide new information about the assessment and correction of the risk of cardiac complications in non-cardiac operations. Despite the proposed new risk assessment scales, the RCRI scale remains the most commonly used, although for certain categories of patients (with oncopathology, in older age groups) the possibility of using specific questionnaires has been shown. In assessing the functional state, it is proposed to use not only a subjective assessment, but also the DASI questionnaire, 6-minute walking test and cardiopulmonary exercise test). At the next stage, it is proposed to evaluate biomarkers, primarily BNP or NT-proBNP, with a normal level – surgery, with an increased level – either an additional examination by a cardiologist or perioperative troponin screening. Currently, the prevailing opinion is that there is no need to examine patients to detect hidden lesions of the coronary arteries (non-invasive tests, coronary angiography), since this leads to excessive examination of patients, delaying the implementation of non-cardiac surgery. The extent to which this approach has an advantage over the previously used one remains to be studied.

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The accuracy of pre-operative (P)-POSSUM scoring and cardiopulmonary exercise testing in predicting morbidity and mortality after pancreatic and liver surgery: A systematic review

Cited by 7 publications

References 39 publications

Ventilatory efficiency measured during sub‐maximal cardiopulmonary exercise testing predicts postoperative outcomes following heart transplantation

Ventilatory efficiency measured during sub‐maximal cardiopulmonary exercise testing predicts postoperative outcomes following heart transplantation

Use of supervised machine learning algorithms in predicting postoperative mortality in gastrointestinal and HPB surgeries

Assessment and Correction of the Cardiac Complications Risk in Non-cardiac Operations – What's New?

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