Urgency Index and Preoperative Index: Prediction of Anastomotic Leakage in Patients Operated For Colorectal Cancer Treatment
Vinícius Evangelista Dias
*
Faculdade Santa Casa BH, Programa de Pós-graduação Stricto Sensu em Medicina, Biomedicina, Belo Horizonte, MG, Brazil and Instituto de Ciências Biológicas e da Saúde, Universidade Iguaçu, Itaperuna, RJ, Brazil and Graduação em Medicina, Faculdade Metropolitana São Carlos, Bom Jesus do Itabapoana, RJ, Brazil.
Homero Terra Padilha
Instituto de Ciências Biológicas e da Saúde, Universidade Iguaçu, Itaperuna, RJ, Brazil.
Lara Vicente Pilar
Instituto de Ciências Biológicas e da Saúde, Universidade Iguaçu, Itaperuna, RJ, Brazil.
Nathália Augusta Gomes
Faculdade Santa Casa BH, Programa de Pós-graduação Stricto Sensu em Medicina, Biomedicina, Belo Horizonte, MG, Brazil.
Aleida Nazareth Soares
Faculdade Santa Casa BH, Programa de Pós-graduação Stricto Sensu em Medicina, Biomedicina, Belo Horizonte, MG, Brazil.
Thais Almeida Marques da Silva
Faculdade Santa Casa BH, Programa de Pós-graduação Stricto Sensu em Medicina, Biomedicina, Belo Horizonte, MG, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background: Several tools are available for predicting the risk of anastomotic leakage (AL) in patients undergoing colectomy for colorectal cancer (CRC) treatment. However, these prognostic indexes have limitations in applicability and efficiency.
Aim: Developing validated, efficient and easily applicable tools to help physicians predict the risk of AL.
Methods: From a meta-analysis and a retrospective cohort, risk factors associated with the development of AL were used to construct and validate two new indexes (Urgency Index and Preoperative Index) to predict AL risk. Sensitivity, specificity, ROC curve, accuracy, and positive and negative predictive value were calculated.
Results: The Urgency Index indicated four variables for AL risk prediction and showed sensitivity of 81.24%, specificity of 75.8%, AUC of 0.841 (95% CI: 0.742-0.939), and accuracy of 76.24%. The Preoperative Index revealed 13 variables and showed 86.56% specificity, 50% sensitivity, 0.699 area under the ROC curve, 83.66% accuracy, 24.24% positive predictive value, and 95.27% negative predictive value.
Conclusion: The two new indexes created for AL risk prediction in patients operated for CRC treatment present good results of specificity, accuracy and reasonable AUC values, and could be used in clinical practice.
Keywords: Colorectal neoplasms, anastomotic leakage, risk factors, prognostic index