Um modelo de predição para seleccionar para co-gestão doentes de cirurgia colo-rectal
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/109428 |
Resumo: | Funding: The work of A.L. Papoila and C. Geraldes is partially sponsored by national funds through Fundação Nacional para a Ciência e Tecnologia, Portugal—FCT under the project PEst-OE/MAT/UI0006/2014. The work of Cátia Salgado was supported by the PhD Scholarship SFRH/BD/121875/2016 from Portuguese Foundation for Science & Technology. S. M. Vieira acknowledges the support by Program Investigador FCT (IF/00833/2014) from FCT, co-funded by the European Social Fund (ESF) through the Operational Program Human Potential (POPH). |
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Um modelo de predição para seleccionar para co-gestão doentes de cirurgia colo-rectalA multivariable prediction model to select colorectal surgical patients for co-managementClinicalColorectal surgery/methodsCooperative behaviorDecision support systemsFailure to rescueHealth carePatient selectionMedicine(all)SDG 3 - Good Health and Well-beingFunding: The work of A.L. Papoila and C. Geraldes is partially sponsored by national funds through Fundação Nacional para a Ciência e Tecnologia, Portugal—FCT under the project PEst-OE/MAT/UI0006/2014. The work of Cátia Salgado was supported by the PhD Scholarship SFRH/BD/121875/2016 from Portuguese Foundation for Science & Technology. S. M. Vieira acknowledges the support by Program Investigador FCT (IF/00833/2014) from FCT, co-funded by the European Social Fund (ESF) through the Operational Program Human Potential (POPH).Introduction: Increased life expectancy leads to older and frailer surgical patients. Co-management between medical and surgical specialities has proven favourable in complex situations. Selection of patients for co-management is full of difficulties. The aim of this study was to develop a clinical decision support tool to select surgical patients for co-management. Material and Methods: Clinical data was collected from patient electronic health records with an ICD-9 code for colorectal surgery from January 2012 to December 2015 at a hospital in Lisbon. The outcome variable consists in co-management signalling. A dataset from 344 patients was used to develop the prediction model and a second data set from 168 patients was used for external validation. Results: Using logistic regression modelling the authors built a five variable (age, burden of comorbidities, ASA-PS status, surgical risk and recovery time) predictive referral model for co-management. This model has an area under the curve (AUC) of 0.86 (95% CI: 0.81 - 0.90), a predictive Brier score of 0.11, a sensitivity of 0.80, a specificity of 0.82 and an accuracy of 81.3%. Discussion: Early referral of high-risk patients may be valuable to guide the decision on the best level of post-operative clinical care. We developed a simple bedside decision tool with a good discriminatory and predictive performance in order to select patients for comanagement. Conclusion: A simple bed-side clinical decision support tool of patients for co-management is viable, leading to potential improvement in early recognition and management of postoperative complications and reducing the ‘failure to rescue’. Generalizability to other clinical settings requires adequate customization and validation.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNHorta, Alexandra BayãoGeraldes, CarlosSalgado, CátiaVieira, SusanaXavier, MiguelPapoila, Ana Luísa2020-12-29T00:03:39Z20202020-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/109428por0870-399XPURE: 27073907https://doi.org/10.20344/AMP.12996info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:53:46Zoai:run.unl.pt:10362/109428Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:41:27.005478Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Um modelo de predição para seleccionar para co-gestão doentes de cirurgia colo-rectal A multivariable prediction model to select colorectal surgical patients for co-management |
title |
Um modelo de predição para seleccionar para co-gestão doentes de cirurgia colo-rectal |
spellingShingle |
Um modelo de predição para seleccionar para co-gestão doentes de cirurgia colo-rectal Horta, Alexandra Bayão Clinical Colorectal surgery/methods Cooperative behavior Decision support systems Failure to rescue Health care Patient selection Medicine(all) SDG 3 - Good Health and Well-being |
title_short |
Um modelo de predição para seleccionar para co-gestão doentes de cirurgia colo-rectal |
title_full |
Um modelo de predição para seleccionar para co-gestão doentes de cirurgia colo-rectal |
title_fullStr |
Um modelo de predição para seleccionar para co-gestão doentes de cirurgia colo-rectal |
title_full_unstemmed |
Um modelo de predição para seleccionar para co-gestão doentes de cirurgia colo-rectal |
title_sort |
Um modelo de predição para seleccionar para co-gestão doentes de cirurgia colo-rectal |
author |
Horta, Alexandra Bayão |
author_facet |
Horta, Alexandra Bayão Geraldes, Carlos Salgado, Cátia Vieira, Susana Xavier, Miguel Papoila, Ana Luísa |
author_role |
author |
author2 |
Geraldes, Carlos Salgado, Cátia Vieira, Susana Xavier, Miguel Papoila, Ana Luísa |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) RUN |
dc.contributor.author.fl_str_mv |
Horta, Alexandra Bayão Geraldes, Carlos Salgado, Cátia Vieira, Susana Xavier, Miguel Papoila, Ana Luísa |
dc.subject.por.fl_str_mv |
Clinical Colorectal surgery/methods Cooperative behavior Decision support systems Failure to rescue Health care Patient selection Medicine(all) SDG 3 - Good Health and Well-being |
topic |
Clinical Colorectal surgery/methods Cooperative behavior Decision support systems Failure to rescue Health care Patient selection Medicine(all) SDG 3 - Good Health and Well-being |
description |
Funding: The work of A.L. Papoila and C. Geraldes is partially sponsored by national funds through Fundação Nacional para a Ciência e Tecnologia, Portugal—FCT under the project PEst-OE/MAT/UI0006/2014. The work of Cátia Salgado was supported by the PhD Scholarship SFRH/BD/121875/2016 from Portuguese Foundation for Science & Technology. S. M. Vieira acknowledges the support by Program Investigador FCT (IF/00833/2014) from FCT, co-funded by the European Social Fund (ESF) through the Operational Program Human Potential (POPH). |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-12-29T00:03:39Z 2020 2020-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/109428 |
url |
http://hdl.handle.net/10362/109428 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
0870-399X PURE: 27073907 https://doi.org/10.20344/AMP.12996 |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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application/pdf |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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