Development and validation of the Ex-Care BR model: a multicentre initiative for identifying Brazilian surgical patients at risk of 30-day in-hospital mortality

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MetadadosDescriçãoIdioma
Autor(es): dc.contributorUniversidade Federal do Rio Grande do Sul (UFRGS)-
Autor(es): dc.contributorHospital de Clínicas de Porto Alegre (HCPA)-
Autor(es): dc.contributorHospital Ernesto Dornelles-
Autor(es): dc.contributorHospital São Domingos-
Autor(es): dc.contributorHospital Marcelino Champagnat-
Autor(es): dc.contributorUniversidade Federal de São Paulo (UNIFESP)-
Autor(es): dc.contributorObras Sociais Irmã Dulce-
Autor(es): dc.contributorHospital São José-
Autor(es): dc.contributorUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)-
Autor(es): dc.contributorIrmandade Santa Casa de Misericórdia Porto Alegre-
Autor(es): dc.contributorUniversidade Federal da Bahia (UFBA)-
Autor(es): dc.contributorUniversidade Federal de Sergipe (UFS)-
Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.contributorHospital de Clínicas de Porto Alegre-
Autor(es): dc.creatorPassos, Sávio C.-
Autor(es): dc.creatorde Jezus Castro, Stela M.-
Autor(es): dc.creatorStahlschmidt, Adriene-
Autor(es): dc.creatorda Silva Neto, Paulo C.-
Autor(es): dc.creatorIrigon Pereira, Paulo J.-
Autor(es): dc.creatorda Cunha Leal, Plínio-
Autor(es): dc.creatorLopes, Maristela B.-
Autor(es): dc.creatordos Reis Falcão, Luiz F.-
Autor(es): dc.creatorde Azevedo, Vera L.F.-
Autor(es): dc.creatorLineburger, Eric B.-
Autor(es): dc.creatorMendes, Florentino F.-
Autor(es): dc.creatorVilela, Ramon M.-
Autor(es): dc.creatorde Araújo Azi, Liana M.T.-
Autor(es): dc.creatorAntunes, Fabrício D.-
Autor(es): dc.creatorBraz, Leandro G.-
Autor(es): dc.creatorStefani, Luciana C.-
Data de aceite: dc.date.accessioned2025-08-21T15:27:58Z-
Data de disponibilização: dc.date.available2025-08-21T15:27:58Z-
Data de envio: dc.date.issued2025-04-29-
Data de envio: dc.date.issued2024-07-01-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1016/j.bja.2024.04.001-
Fonte completa do material: dc.identifierhttps://hdl.handle.net/11449/299942-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/299942-
Descrição: dc.descriptionBackground: Surgical risk stratification is crucial for enhancing perioperative assistance and allocating resources efficiently. However, existing models may not capture the complexity of surgical care in Brazil. Using data from various healthcare settings nationwide, we developed a new risk model for 30-day in-hospital mortality (the Ex-Care BR model). Methods: A retrospective cohort study was conducted in 10 hospitals from different geographic regions in Brazil. Data were analysed using multilevel logistic regression models. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC), Brier score, and calibration plots. Derivation and validation cohorts were randomly assigned. Results: A total of 107,372 patients were included, and 30-day in-hospital mortality was 2.1% (n=2261). The final risk model comprised four predictors related to the patient and surgery (age, ASA physical status classification, surgical urgency, and surgical size), and the random effect related to hospitals. The model showed excellent discrimination (AUROC=0.93, 95% confidence interval [CI], 0.93–0.94), calibration, and overall performance (Brier score=0.017) in the derivation cohort (n=75,094). Similar results were observed in the validation cohort (n=32,278) (AUROC=0.93, 95% CI, 0.92–0.93). Conclusions: The Ex-Care BR is the first model to consider regional and organisational peculiarities of the Brazilian surgical scene, in addition to patient and surgical factors. It is particularly useful for identifying high-risk surgical patients in situations demanding efficient allocation of limited resources. However, a thorough exploration of mortality variations among hospitals is essential for a comprehensive understanding of risk. Clinical trial registration: NCT05796024.-
Descrição: dc.descriptionGraduate Program in Medical Sciences School of Medicine Universidade Federal do Rio Grande do Sul (UFRGS)-
Descrição: dc.descriptionAnesthesiology and Perioperative Medicine Service Hospital de Clínicas de Porto Alegre (HCPA)-
Descrição: dc.descriptionDepartment of Statistics Institute of Mathematics and Statistics Universidade Federal do Rio Grande do Sul (UFRGS)-
Descrição: dc.descriptionDepartment of Anesthesiology Hospital Ernesto Dornelles-
Descrição: dc.descriptionHospital São Domingos-
Descrição: dc.descriptionHospital Marcelino Champagnat-
Descrição: dc.descriptionDepartment of Surgery School of Medicine Universidade Federal de São Paulo (UNIFESP)-
Descrição: dc.descriptionObras Sociais Irmã Dulce-
Descrição: dc.descriptionHospital São José-
Descrição: dc.descriptionDepartment of Surgical Clinic School of Medicine Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)-
Descrição: dc.descriptionDepartment of Anesthesiology Irmandade Santa Casa de Misericórdia Porto Alegre-
Descrição: dc.descriptionDepartment of Anesthesiology and Surgery School of Medicine Universidade Federal da Bahia (UFBA)-
Descrição: dc.descriptionDepartment of Medicine School of Medicine Universidade Federal de Sergipe (UFS)-
Descrição: dc.descriptionDepartment of Surgical Specialties and Anesthesiology School of Medicine Universidade Estadual Paulista (UNESP)-
Descrição: dc.descriptionDepartment of Surgery School of Medicine Universidade Federal do Rio Grande do Sul (UFRGS) Hospital de Clínicas de Porto Alegre-
Descrição: dc.descriptionDepartment of Surgical Specialties and Anesthesiology School of Medicine Universidade Estadual Paulista (UNESP)-
Formato: dc.format125-134-
Idioma: dc.languageen-
Relação: dc.relationBritish Journal of Anaesthesia-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectmortality-
Palavras-chave: dc.subjectperioperative death-
Palavras-chave: dc.subjectpostoperative outcome-
Palavras-chave: dc.subjectprediction model-
Palavras-chave: dc.subjectrisk assessment-
Palavras-chave: dc.subjectrisk factors-
Título: dc.titleDevelopment and validation of the Ex-Care BR model: a multicentre initiative for identifying Brazilian surgical patients at risk of 30-day in-hospital mortality-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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