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Preoperative Prediction of the Occurrence and Severity of Complications After Esophagectomy for Cancer With Use of a Nomogram Sjoerd M. Lagarde, MD, Johannes B. Reitsma, MD, Anna-Karin D. Maris, MS, Mark I. van Berge Henegouwen, MD, Olivier R.C. Busch, MD, Hugo Obertop, MD, Aelko H. Zwinderman, AH, PhD, J. Jan B. van Lanschot, MD The Annals of Thoracic Surgery Volume 85, Issue 6, Pages (June 2008) DOI: /j.athoracsur Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions
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Fig 1 Nomogram for prediction of severity of complications with use of preoperative risk-factors. Complication categories are graded according to severity; no complications (category 0), minor to moderate complications (category 1), and major complications (category 2). Instruction: Locate the Age on the axis. Determine how many points the patient receives. Repeat this for each axis. Sum the points for all predictors and locate the sum on the Total points axis. Draw a line straight down to the bar graphs. Bar graphs represent the chance for an individual patient after esophagectomy for cancer to develop major, minor-to-moderate, or no complications. (FEV1 = forced expiratory volume in the first second; MI = myocardial infarction; TIA = transient ischemic attack.) The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions
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Fig 2 Distribution of risk score (by means of the total points derived by the nomogram) for the prediction of the severity of complications with use of preoperative risk factors. Complication categories are graded according to severity; no complications (█; category 0), minor to moderate complications (♦; category 1), and severe complications (▾; category 2). No complications: n = 197, mean = 15.4, SD = 5.7, SE = 0.41; CI = 14.6 to Minor complications: n = 354, mean = 18.2, SD = 6.0, SE = 0.32; CI = 17.6 to Major complications: n = 112, mean = 21.6, SD = 7.4, SE = 0.70; CI = 20.2 to (CI = confidence interval; SD = standard deviation; SE = standard error of the mean.) The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions
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Fig 3 Observed versus predicted plots for the prediction of the severity of complications in the nomogram development set. The dotted line represents an optimal prediction of the predictive model. The three outcome categories are represented by the three lines which indicate no complications (█), minor to moderate complications (▾), and major complications (). Observed proportions for each of the three categories are calculated for quartiles of the risk score and given with their 95% confidence interval. The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions
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Fig 4 Observed versus predicted plots for the prediction of the severity of complications in the nomogram validation set. The dotted line represents an optimal performance of the predictive model. The three outcome categories are represented by the three lines which indicate no complications (█), minor to moderate complications (▾), and major complications (). Observed proportions for each of the three categories are calculated for quartiles of the risk score and given with their 95% confidence interval. The Annals of Thoracic Surgery , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions
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