Postoperative 30-day mortality in patients undergoing surgery for colorectal cancer: development of a prognostic model using administrative claims data

S de Vries; D B Jeffe; N O Davidson; A D Deshpande; M Schootman

doi:10.1007/s10552-014-0451-x

Back

Postoperative 30-day mortality in patients undergoing surgery for colorectal cancer: development of a prognostic model using administrative claims data

Journal article

Peer reviewed

Postoperative 30-day mortality in patients undergoing surgery for colorectal cancer: development of a prognostic model using administrative claims data

S de Vries, D B Jeffe, N O Davidson, A D Deshpande and M Schootman

Cancer causes & control, Vol.25(11), pp.1503-1512

11/2014

DOI: 10.1007/s10552-014-0451-x

PMCID: PMC4216620

PMID: 25104569

View Online

Abstract

To develop a prognostic model to predict 30-day mortality following colorectal cancer (CRC) surgery using the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked data and to assess whether race/ethnicity, neighborhood, and hospital characteristics influence model performance. We included patients aged 66 years and older from the linked 2000-2005 SEER-Medicare database. Outcome included 30-day mortality, both in-hospital and following discharge. Potential prognostic factors included tumor, treatment, sociodemographic, hospital, and neighborhood characteristics (census-tract-poverty rate). We performed a multilevel logistic regression analysis to account for nesting of CRC patients within hospitals. Model performance was assessed using the area under the receiver operating characteristic curve (AUC) for discrimination and the Hosmer-Lemeshow goodness-of-fit test for calibration. In a model that included all prognostic factors, important predictors of 30-day mortality included age at diagnosis, cancer stage, and mode of presentation. Race/ethnicity, census-tract-poverty rate, and hospital characteristics were independently associated with 30-day mortality, but they did not influence model performance. Our SEER-Medicare model achieved moderate discrimination (AUC = 0.76), despite suboptimal calibration. We developed a prognostic model that included tumor, treatment, sociodemographic, hospital, and neighborhood predictors. Race/ethnicity, neighborhood, and hospital characteristics did not improve model performance compared with previously developed models.

Colorectal Neoplasms - mortality

Models, Theoretical

Colorectal Neoplasms - surgery

United States - epidemiology

SEER Program

Prognosis

Medicare

Humans

Postoperative Period

Male

Aged, 80 and over

Female

Aged

Databases, Factual

Details

Title: Subtitle: Postoperative 30-day mortality in patients undergoing surgery for colorectal cancer: development of a prognostic model using administrative claims data
Creators: S de Vries - Division of Health Behavior Research, Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA
D B Jeffe
N O Davidson
A D Deshpande
M Schootman
Resource Type: Journal article
Publication Details: Cancer causes & control, Vol.25(11), pp.1503-1512
DOI: 10.1007/s10552-014-0451-x
PMID: 25104569
PMCID: PMC4216620
NLM abbreviation: Cancer Causes Control
ISSN: 0957-5243
eISSN: 1573-7225
Publisher: Netherlands
Grant note: R01 CA137750 / NCI NIH HHS R37 HL038180 / NHLBI NIH HHS CA112159 / NCI NIH HHS P30 CA091842 / NCI NIH HHS R01 DK056260 / NIDDK NIH HHS P30 CA91842 / NCI NIH HHS R01 HL038180 / NHLBI NIH HHS R01 CA112159 / NCI NIH HHS UL1 TR000448 / NCATS NIH HHS P30 DK052574 / NIDDK NIH HHS
Language: English
Date published: 11/2014
Academic Unit: Epidemiology
Record Identifier: 9983995138202771

Metrics

14 Record Views

18 Times Cited - Web of Science