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Article Open Access

Development and external validation of a novel score for predicting postoperative 30‑day mortality in tumor craniotomy patients: A cross‑sectional diagnostic study

  • Authors:
    • Yufei Liu
    • Haofei Hu
    • Yong Han
    • Zongyang Li
    • Jihu Yang
    • Xiejun Zhang
    • Lei Chen
    • Fanfan Chen
    • Weiping Li
    • Guodong Huang
  • View Affiliations / Copyright

    Affiliations: Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong 518035, P.R. China, Shenzhen University Health Science Center, Shenzhen University, Shenzhen, Guangdong 518000, P.R. China, Shenzhen University Health Science Center, Shenzhen University, Shenzhen, Guangdong 518000, P.R. China, Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong 518035, P.R. China
    Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 205
    |
    Published online on: March 12, 2024
       https://doi.org/10.3892/ol.2024.14338
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Abstract

The identification of patients with craniotomy at high risk for postoperative 30‑day mortality may contribute to achieving targeted delivery of interventions. The present study aimed to develop a personalized nomogram and scoring system for predicting the risk of postoperative 30‑day mortality in such patients. In this retrospective cross‑sectional study, 18,642 patients with craniotomy were stratified into a training cohort (n=7,800; year of surgery, 2012‑2013) and an external validation cohort (n=10,842; year of surgery, 2014‑2015). The least absolute shrinkage and selection operator (LASSO) model was used to select the most important variables among the candidate variables. Furthermore, a stepwise logistic regression model was established to screen out the risk factors based on the predictors chosen by the LASSO model. The model and a nomogram were constructed. The area under the receiver operating characteristic (ROC) curve (AUC) and calibration plot analysis were used to assess the model's discrimination ability and accuracy. The associated risk factors were categorized according to clinical cutoff points to create a scoring model for postoperative 30‑day mortality. The total score was divided into four risk categories: Extremely high, high, intermediate and low risk. The postoperative 30‑day mortality rates were 2.43 and 2.58% in the training and validation cohort, respectively. A simple nomogram and scoring system were developed for predicting the risk of postoperative 30‑day mortality according to the white blood cell count; hematocrit and blood urea nitrogen levels; age range; functional health status; and incidence of disseminated cancer cells. The ROC AUC of the nomogram was 0.795 (95% CI: 0.764 to 0.826) in the training cohort and it was 0.738 (95% CI: 0.7091 to 0.7674) in the validation cohort. The calibration demonstrated a perfect fit between the predicted 30‑day mortality risk and the observed 30‑day mortality risk. Low, intermediate, high and extremely high risk statuses for 30‑day mortality were associated with total scores of (‑1.5 to ‑1), (‑0.5 to 0.5), (1 to 2) and (2.5 to 9), respectively. A personalized nomogram and scoring system for predicting postoperative 30‑day mortality in adult patients who underwent craniotomy were developed and validated, and individuals at high risk of 30‑day mortality were able to be identified.
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Spandidos Publications style
Liu Y, Hu H, Han Y, Li Z, Yang J, Zhang X, Chen L, Chen F, Li W, Huang G, Huang G, et al: Development and external validation of a novel score for predicting postoperative 30‑day mortality in tumor craniotomy patients: A cross‑sectional diagnostic study. Oncol Lett 27: 205, 2024.
APA
Liu, Y., Hu, H., Han, Y., Li, Z., Yang, J., Zhang, X. ... Huang, G. (2024). Development and external validation of a novel score for predicting postoperative 30‑day mortality in tumor craniotomy patients: A cross‑sectional diagnostic study. Oncology Letters, 27, 205. https://doi.org/10.3892/ol.2024.14338
MLA
Liu, Y., Hu, H., Han, Y., Li, Z., Yang, J., Zhang, X., Chen, L., Chen, F., Li, W., Huang, G."Development and external validation of a novel score for predicting postoperative 30‑day mortality in tumor craniotomy patients: A cross‑sectional diagnostic study". Oncology Letters 27.5 (2024): 205.
Chicago
Liu, Y., Hu, H., Han, Y., Li, Z., Yang, J., Zhang, X., Chen, L., Chen, F., Li, W., Huang, G."Development and external validation of a novel score for predicting postoperative 30‑day mortality in tumor craniotomy patients: A cross‑sectional diagnostic study". Oncology Letters 27, no. 5 (2024): 205. https://doi.org/10.3892/ol.2024.14338
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Spandidos Publications style
Liu Y, Hu H, Han Y, Li Z, Yang J, Zhang X, Chen L, Chen F, Li W, Huang G, Huang G, et al: Development and external validation of a novel score for predicting postoperative 30‑day mortality in tumor craniotomy patients: A cross‑sectional diagnostic study. Oncol Lett 27: 205, 2024.
APA
Liu, Y., Hu, H., Han, Y., Li, Z., Yang, J., Zhang, X. ... Huang, G. (2024). Development and external validation of a novel score for predicting postoperative 30‑day mortality in tumor craniotomy patients: A cross‑sectional diagnostic study. Oncology Letters, 27, 205. https://doi.org/10.3892/ol.2024.14338
MLA
Liu, Y., Hu, H., Han, Y., Li, Z., Yang, J., Zhang, X., Chen, L., Chen, F., Li, W., Huang, G."Development and external validation of a novel score for predicting postoperative 30‑day mortality in tumor craniotomy patients: A cross‑sectional diagnostic study". Oncology Letters 27.5 (2024): 205.
Chicago
Liu, Y., Hu, H., Han, Y., Li, Z., Yang, J., Zhang, X., Chen, L., Chen, F., Li, W., Huang, G."Development and external validation of a novel score for predicting postoperative 30‑day mortality in tumor craniotomy patients: A cross‑sectional diagnostic study". Oncology Letters 27, no. 5 (2024): 205. https://doi.org/10.3892/ol.2024.14338
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