1844 ACCURACY OF THE CHARLSON COMORBIDITY INDEX (CCI) IN PREDICTING IN-HOSPITAL MORTALITY (IHM) IN PATIENTS TREATED WITH RADICAL CYSTECTOMY (RC)
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Résumé
You have accessJournal of UrologyBladder Cancer: Invasive1 Apr 20111844 ACCURACY OF THE CHARLSON COMORBIDITY INDEX (CCI) IN PREDICTING IN-HOSPITAL MORTALITY (IHM) IN PATIENTS TREATED WITH RADICAL CYSTECTOMY (RC) Daniel Liberman, Maxine Sun, Claudio Jeldres, Firas Abdollah, Jan Schmitges, Orchidee Djahangirian, Daniel Pharand, Shahrokh F. Shariat, Paul Perrotte, and Pierre I. Karakiewicz Daniel LibermanDaniel Liberman Montreal, Canada More articles by this author , Maxine SunMaxine Sun Montreal, Canada More articles by this author , Claudio JeldresClaudio Jeldres Montreal, Canada More articles by this author , Firas AbdollahFiras Abdollah Milan, Italy More articles by this author , Jan SchmitgesJan Schmitges Hamburg, Germany More articles by this author , Orchidee DjahangirianOrchidee Djahangirian Montreal, Canada More articles by this author , Daniel PharandDaniel Pharand Montreal, Canada More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat New York, NY More articles by this author , Paul PerrottePaul Perrotte Montreal, Canada More articles by this author , and Pierre I. KarakiewiczPierre I. Karakiewicz Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1877AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES CCI was developed to predict one-year mortality in medical patients. Currently, its use is widespread in surgical patients, including those treated with RC for urothelial carcinoma of the bladder. However, its accuracy in these patients was never tested. To address this limitation we tested the accuracy of CCI in predicting IHM after RC. METHODS We relied on 12274 RC records for patients treated between 1998 and 2007, within the Nationwide Inpatient Sample. IHM rates were stratified according to CCI. Univariable and multivariable logistic regression analyse tested the independent predictor status of CCI as a determinant of IHM. Predictive accuracy estimates were quantified with the area under the curve (AUC), after 200 bootstrap resamples. RESULTS Average patient age was 68.5 years (median 70, range 40–95). CCI was 0 vs. 1 vs. 2 vs. 3 vs. ≥4 in respectively 68.1 vs. 22.9 vs. 4.9 vs. 3.0 vs. 1.1% of patients. The overall IHM rate was 2.4%, and it was 1.8 vs. 3.1 vs. 4.0 vs. 3.8 vs. 12.7% for patients with CCI of respectively 0 vs. 1 vs. 2 vs. 3 vs. ≥4 (p<0.001). The accuracy of CCI to predict IHM was 59.6% vs. 64.9% for age vs. 49.9% for gender vs. 48.3% for race vs. 52.8% for year of surgery vs. 56.6% for annual hospital volume vs. 54.3% for hospital teaching status. In multivariable analyses, CCI achieved independent predictor status of IHM. The accuracy of the final model was 68.1%. CONCLUSIONS Although CCI is an independent predictor of IHM after RC, its ability to identify individual IHM event is relatively poor, as it misclassifies virtually 40% of IHM events. The consideration of other variables resulted in an important improvement in the ability to predict IHM. In consequence, a RC-specific comorbidity index may be warranted. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185 Issue 4S April 2011 Page: e740 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Metrics Author Information Daniel Liberman Montreal, Canada More articles by this author Maxine Sun Montreal, Canada More articles by this author Claudio Jeldres Montreal, Canada More articles by this author Firas Abdollah Milan, Italy More articles by this author Jan Schmitges Hamburg, Germany More articles by this author Orchidee Djahangirian Montreal, Canada More articles by this author Daniel Pharand Montreal, Canada More articles by this author Shahrokh F. Shariat New York, NY More articles by this author Paul Perrotte Montreal, Canada More articles by this author Pierre I. Karakiewicz Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,016 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».