Prediction of 30-day, 90-day, and 1-year mortality after colorectal cancer surgery using a data-driven approach

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  • Karoline Bendix Bräuner
  • Andi Tsouchnika
  • Maliha Mashkoor
  • Ross Williams
  • Andreas Weinberger Rosen
  • Morten Frederik Schlaikjær Hartwig
  • Bulut, Mustafa
  • Niclas Dohrn
  • Peter Rijnbeek
  • Gögenur, Ismail

Purpose: To develop prediction models for short-term mortality risk assessment following colorectal cancer surgery. Methods: Data was harmonized from four Danish observational health databases into the Observational Medical Outcomes Partnership Common Data Model. With a data-driven approach using the Least Absolute Shrinkage and Selection Operator logistic regression on preoperative data, we developed 30-day, 90-day, and 1-year mortality prediction models. We assessed discriminative performance using the area under the receiver operating characteristic and precision-recall curve and calibration using calibration slope, intercept, and calibration-in-the-large. We additionally assessed model performance in subgroups of curative, palliative, elective, and emergency surgery. Results: A total of 57,521 patients were included in the study population, 51.1% male and with a median age of 72 years. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.88, 0.878, and 0.861 for 30-day, 90-day, and 1-year mortality, respectively, and a calibration-in-the-large of 1.01, 0.99, and 0.99. The overall incidence of mortality were 4.48% for 30-day mortality, 6.64% for 90-day mortality, and 12.8% for 1-year mortality, respectively. Subgroup analysis showed no improvement of discrimination or calibration when separating the cohort into cohorts of elective surgery, emergency surgery, curative surgery, and palliative surgery. Conclusion: We were able to train prediction models for the risk of short-term mortality on a data set of four combined national health databases with good discrimination and calibration. We found that one cohort including all operated patients resulted in better performing models than cohorts based on several subgroups.

Original languageEnglish
Article number31
JournalInternational Journal of Colorectal Disease
Volume39
Issue number1
Number of pages11
ISSN0179-1958
DOIs
Publication statusPublished - 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

    Research areas

  • Colorectal cancer, Machine learning, Mortality, Postoperative, Prediction model

ID: 390407676