Validation of the PreOperative Score to predict Post-Operative Mortality (POSPOM) in Dutch non-cardiac surgery patients (2024)

TRACE Study investigators (2022). Validation of the PreOperative Score to predict Post-Operative Mortality (POSPOM) in Dutch non-cardiac surgery patients. BMC Anesthesiology, 22(1), 58. Article 58. https://doi.org/10.1186/s12871-022-01564-1

TRACE Study investigators. / Validation of the PreOperative Score to predict Post-Operative Mortality (POSPOM) in Dutch non-cardiac surgery patients. In: BMC Anesthesiology. 2022 ; Vol. 22, No. 1. pp. 58.

@article{4941e23b70704d349f649fe65a8e7169,

title = "Validation of the PreOperative Score to predict Post-Operative Mortality (POSPOM) in Dutch non-cardiac surgery patients",

abstract = "BACKGROUND: Standardized risk assessment tools can be used to identify patients at higher risk for postoperative complications and death. In this study, we validate the PreOperative Score to predict Post-Operative Mortality (POSPOM) for in-hospital mortality in a large cohort of non-cardiac surgery patients. In addition, the performance of POSPOM to predict postoperative complications was studied.METHODS: Data from the control cohort of the TRACE (routine posTsuRgical Anesthesia visit to improve patient outComE) study was analysed. POSPOM scores for each patient were calculated post-hoc. Observed in-hospital mortality was compared with predicted mortality according to POSPOM. Discrimination was assessed by receiver operating characteristic curves with C-statistics for in-hospital mortality and postoperative complications. To describe the performance of POSPOM sensitivity, specificity, negative predictive values, and positive predictive values were calculated. For in-hospital mortality, calibration was assessed by a calibration plot.RESULTS: In 2490 patients, the observed in-hospital mortality was 0.5%, compared to 1.3% as predicted by POSPOM. 27.1% of patients had at least one postoperative complication of which 22.4% had a major complication. For in-hospital mortality, POSPOM showed strong discrimination with a C-statistic of 0.86 (95% CI, 0.78-0.93). For the prediction of complications, the discrimination was poor to fair depending on the severity of the complication. The calibration plot showed poor calibration of POSPOM with an overestimation of in-hospital mortality.CONCLUSION: Despite the strong discriminatory performance, POSPOM showed poor calibration with an overestimation of in-hospital mortality. Performance of POSPOM for the prediction of any postoperative complication was poor but improved according to severity.",

keywords = "Calibration, Complications, Discrimination, In-hospital mortality, Outcome, Peri-operative, Risk assessment, Validation",

author = "{TRACE Study investigators} and Annick Stolze and {van de Garde}, {Ewoudt M W} and Posthuma, {Linda M} and Hollmann, {Markus W} and {de Korte-de Boer}, Dianne and Smit-Fun, {Val{\'e}rie M} and Buhre, {Wolfgang F F A} and Christa Boer and Noordzij, {Peter G}",

note = "Funding Information: The TRACE study was supported by The Netherlands Organization for Health Research and Development (ZonMw), the Dutch Society for Anesthesia (NVA), and the individual participating medical centers. The TRACE study was also supported by a grant from the European Society of Anesthesiology and Intensive Care (ESAIC). It is furthermore supported by the Dutch Society for Surgery (NVvH) and the umbrella organization of nine health insurers in The Netherlands (Zorgverzekeraars Nederland). The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. Funding Information: MWH reports grants from ZonMW & Zorgverzekeraars Nederland, grants from Dutch Society of Anesthesiology (NvA), grants from European Society of Anesthesiology and Intensive Care (ESAIC), during the conduct of the study. He is executive section editor for Pharmacology for Anesthesia & Analgesia, section editor for Anesthesiology of the Journal of Clinical Medicine, received grants, honoraria for lectures and is advisory board member for Eurocept BV, received grants and honoraria for lectures from BBraun, received grants and honoraria for lectures from Edwards and received grants and honoraria for lectures from Behring, outside the submitted work. WFFAB reports grants from ZonMW & Zorgverzekeraars Nederland and grants from ESAIC during the conduct of the study. He has received funding from the European Commission (EU-Horizon 2020) and InterReg EU outside the presented study. His department has received funding from Medtronic and WFFAB is member of an advice committee of Medtronic. All honorarium is directed to the department and not to him as a person. All other authors declare no conflict of interests. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = mar,

day = "3",

doi = "10.1186/s12871-022-01564-1",

language = "English",

volume = "22",

pages = "58",

journal = "BMC Anesthesiology",

issn = "1471-2253",

publisher = "BioMed Central",

number = "1",

}

TRACE Study investigators 2022, 'Validation of the PreOperative Score to predict Post-Operative Mortality (POSPOM) in Dutch non-cardiac surgery patients', BMC Anesthesiology, vol. 22, no. 1, 58, pp. 58. https://doi.org/10.1186/s12871-022-01564-1

Validation of the PreOperative Score to predict Post-Operative Mortality (POSPOM) in Dutch non-cardiac surgery patients. / TRACE Study investigators.
In: BMC Anesthesiology, Vol. 22, No. 1, 58, 03.03.2022, p. 58.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Validation of the PreOperative Score to predict Post-Operative Mortality (POSPOM) in Dutch non-cardiac surgery patients

AU - TRACE Study investigators

AU - Stolze, Annick

AU - van de Garde, Ewoudt M W

AU - Posthuma, Linda M

AU - Hollmann, Markus W

AU - de Korte-de Boer, Dianne

AU - Smit-Fun, Valérie M

AU - Buhre, Wolfgang F F A

AU - Boer, Christa

AU - Noordzij, Peter G

N1 - Funding Information:The TRACE study was supported by The Netherlands Organization for Health Research and Development (ZonMw), the Dutch Society for Anesthesia (NVA), and the individual participating medical centers. The TRACE study was also supported by a grant from the European Society of Anesthesiology and Intensive Care (ESAIC). It is furthermore supported by the Dutch Society for Surgery (NVvH) and the umbrella organization of nine health insurers in The Netherlands (Zorgverzekeraars Nederland). The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.Funding Information:MWH reports grants from ZonMW & Zorgverzekeraars Nederland, grants from Dutch Society of Anesthesiology (NvA), grants from European Society of Anesthesiology and Intensive Care (ESAIC), during the conduct of the study. He is executive section editor for Pharmacology for Anesthesia & Analgesia, section editor for Anesthesiology of the Journal of Clinical Medicine, received grants, honoraria for lectures and is advisory board member for Eurocept BV, received grants and honoraria for lectures from BBraun, received grants and honoraria for lectures from Edwards and received grants and honoraria for lectures from Behring, outside the submitted work. WFFAB reports grants from ZonMW & Zorgverzekeraars Nederland and grants from ESAIC during the conduct of the study. He has received funding from the European Commission (EU-Horizon 2020) and InterReg EU outside the presented study. His department has received funding from Medtronic and WFFAB is member of an advice committee of Medtronic. All honorarium is directed to the department and not to him as a person. All other authors declare no conflict of interests.Publisher Copyright:© 2022, The Author(s).

PY - 2022/3/3

Y1 - 2022/3/3

N2 - BACKGROUND: Standardized risk assessment tools can be used to identify patients at higher risk for postoperative complications and death. In this study, we validate the PreOperative Score to predict Post-Operative Mortality (POSPOM) for in-hospital mortality in a large cohort of non-cardiac surgery patients. In addition, the performance of POSPOM to predict postoperative complications was studied.METHODS: Data from the control cohort of the TRACE (routine posTsuRgical Anesthesia visit to improve patient outComE) study was analysed. POSPOM scores for each patient were calculated post-hoc. Observed in-hospital mortality was compared with predicted mortality according to POSPOM. Discrimination was assessed by receiver operating characteristic curves with C-statistics for in-hospital mortality and postoperative complications. To describe the performance of POSPOM sensitivity, specificity, negative predictive values, and positive predictive values were calculated. For in-hospital mortality, calibration was assessed by a calibration plot.RESULTS: In 2490 patients, the observed in-hospital mortality was 0.5%, compared to 1.3% as predicted by POSPOM. 27.1% of patients had at least one postoperative complication of which 22.4% had a major complication. For in-hospital mortality, POSPOM showed strong discrimination with a C-statistic of 0.86 (95% CI, 0.78-0.93). For the prediction of complications, the discrimination was poor to fair depending on the severity of the complication. The calibration plot showed poor calibration of POSPOM with an overestimation of in-hospital mortality.CONCLUSION: Despite the strong discriminatory performance, POSPOM showed poor calibration with an overestimation of in-hospital mortality. Performance of POSPOM for the prediction of any postoperative complication was poor but improved according to severity.

AB - BACKGROUND: Standardized risk assessment tools can be used to identify patients at higher risk for postoperative complications and death. In this study, we validate the PreOperative Score to predict Post-Operative Mortality (POSPOM) for in-hospital mortality in a large cohort of non-cardiac surgery patients. In addition, the performance of POSPOM to predict postoperative complications was studied.METHODS: Data from the control cohort of the TRACE (routine posTsuRgical Anesthesia visit to improve patient outComE) study was analysed. POSPOM scores for each patient were calculated post-hoc. Observed in-hospital mortality was compared with predicted mortality according to POSPOM. Discrimination was assessed by receiver operating characteristic curves with C-statistics for in-hospital mortality and postoperative complications. To describe the performance of POSPOM sensitivity, specificity, negative predictive values, and positive predictive values were calculated. For in-hospital mortality, calibration was assessed by a calibration plot.RESULTS: In 2490 patients, the observed in-hospital mortality was 0.5%, compared to 1.3% as predicted by POSPOM. 27.1% of patients had at least one postoperative complication of which 22.4% had a major complication. For in-hospital mortality, POSPOM showed strong discrimination with a C-statistic of 0.86 (95% CI, 0.78-0.93). For the prediction of complications, the discrimination was poor to fair depending on the severity of the complication. The calibration plot showed poor calibration of POSPOM with an overestimation of in-hospital mortality.CONCLUSION: Despite the strong discriminatory performance, POSPOM showed poor calibration with an overestimation of in-hospital mortality. Performance of POSPOM for the prediction of any postoperative complication was poor but improved according to severity.

KW - Calibration

KW - Complications

KW - Discrimination

KW - In-hospital mortality

KW - Outcome

KW - Peri-operative

KW - Risk assessment

KW - Validation

UR - http://www.scopus.com/inward/record.url?scp=85125690437&partnerID=8YFLogxK

U2 - 10.1186/s12871-022-01564-1

DO - 10.1186/s12871-022-01564-1

M3 - Article

C2 - 35240985

SN - 1471-2253

VL - 22

SP - 58

JO - BMC Anesthesiology

JF - BMC Anesthesiology

IS - 1

M1 - 58

ER -

TRACE Study investigators. Validation of the PreOperative Score to predict Post-Operative Mortality (POSPOM) in Dutch non-cardiac surgery patients. BMC Anesthesiology. 2022 Mar 3;22(1):58. 58. doi: 10.1186/s12871-022-01564-1