eprintid: 10121623
rev_number: 14
eprint_status: archive
userid: 608
dir: disk0/10/12/16/23
datestamp: 2021-02-15 12:32:19
lastmod: 2021-12-13 23:33:03
status_changed: 2021-02-15 12:32:19
type: article
metadata_visibility: show
creators_name: Oakland, K
creators_name: Cosentino, D
creators_name: Cross, T
creators_name: Bucknall, C
creators_name: Dorudi, S
creators_name: Walker, D
title: External validation of the Surgical Outcome Risk Tool (SORT) in 3305 abdominal surgery patients in the independent sector in the UK
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D16
divisions: G88
keywords: Outcomes, Pre-assessment, Risk assessment, Surgery
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abstract: BACKGROUND: Assessing the risk of post-surgical mortality is a key component of pre-surgical planning. The Surgical Outcome Risk Tool (SORT) uses pre-operative variables to predict 30-day mortality. The aim of this study was to externally validate SORT in patients undergoing major abdominal surgery. METHODS: Data were collected from patients treated in five independent hospitals in the UK. Individualised SORT scores were calculated, and area under the receiver operating characteristic (AUROC) and precision-recall curves (PRC) plus 95% confidence intervals (CI) were drawn to test the ability of SORT to identify in-hospital death. Outcomes of patients with a SORT predicted risk of mortality of ≥ 5% (high risk) were compared to those with a predicted risk of < 5% (standard risk). RESULTS: The study population comprised 3305 patients, mean age 51 years, 2783 (84.2%) underwent elective surgery most frequently involving the colon (24.6%), or liver, pancreas or gallbladder (18.2%). Overall, 1551 (46.9%) patients were admitted to ICU and 29 (0.88%) died. The AUROC of SORT for discriminating patients at risk of death in hospital was 0.899 (95% CI 0.849 to 0.949) and the PRC 0.247. In total, 72 (2.18%) patients were stratified as high risk. There were more unplanned ICU admissions and deaths in this group compared to the standard risk group (25.0% and 3.3%, versus 3.1% and 0.5%, respectively). CONCLUSION: We externally validated SORT in a large population of abdominal surgery patients. SORT performed well in patients with lower risk profiles, but underpredicted adverse outcomes in the higher risk group.
date: 2021-01-26
date_type: published
official_url: https://doi.org/10.1186/s13741-020-00173-1
oa_status: green
full_text_type: pub
pmcid: PMC7836595
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1845949
doi: 10.1186/s13741-020-00173-1
pii: 10.1186/s13741-020-00173-1
lyricists_name: Walker, David
lyricists_id: DWALK67
actors_name: Bracey, Alan
actors_id: ABBRA90
actors_role: owner
full_text_status: public
publication: Perioperative Medicine
volume: 10
article_number: 4
event_location: England
citation:        Oakland, K;    Cosentino, D;    Cross, T;    Bucknall, C;    Dorudi, S;    Walker, D;      (2021)    External validation of the Surgical Outcome Risk Tool (SORT) in 3305 abdominal surgery patients in the independent sector in the UK.                   Perioperative Medicine , 10     , Article 4.  10.1186/s13741-020-00173-1 <https://doi.org/10.1186/s13741-020-00173-1>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10121623/1/s13741-020-00173-1.pdf