The HOMEDAYS prediction model accurately estimated median days at home within 90 days after elective gastrointestinal cancer surgery, demonstrating strong accuracy with a mean absolute error of 8.67.
Cohort (n=91,270)
Sí
Can the HOMEDAYS model accurately predict days at home within 90 days after elective gastrointestinal cancer surgery?
The HOMEDAYS prediction model accurately estimates days at home within 90 days after elective gastrointestinal cancer surgery, enabling individualized patient-centered risk communication.
BACKGROUND: Patient-centered outcomes after gastrointestinal cancer surgery are poorly captured by traditional metrics, limiting effective preoperative counseling. Days at home within 90 days after surgery (DAH-90) integrates survival and healthcare utilization but lacks a clinically applicable prediction tool. STUDY DESIGN: Adults undergoing elective gastrointestinal cancer resection in Ontario, Canada (2003-2021) were identified using population-based administrative data. A multivariable prediction model (HOMEDAYS) was developed using quantile regression to estimate median DAH-90 based on preoperative patient, cancer, and treatment factors. Model performance was assessed using mean absolute error (MAE), calibration (slope, intercept, decile plots), and discrimination (g-index), with internal validation via 500-bootstrap resampling and prespecified sensitivity analyses. RESULTS: Among 91,270 patients, median DAH-90 was 82 days (IQR 77-85). The final model incorporated 23 predictors with 3 interaction terms and modeled age using restricted cubic splines. Performance demonstrated strong accuracy (MAE 8.67), good calibration (slope 1.0, intercept 0.29), and discrimination (g-index 3.27). Optimism-corrected metrics remained stable (MAE 8.68; slope 1.0; intercept 0.29; g-index 3.26). Calibration across deciles showed minimal deviation between predicted and observed DAH-90 (0.1-0.6 days). Model performance was robust across multiple sensitivity analyses, including alternative outcome definitions and additional predictors. CONCLUSIONS: HOMEDAYS provides accurate, internally validated predictions of DAH-90 using preoperative variables, enabling individualized, patient-centered risk communication for elective gastrointestinal cancer surgery. This tool may enhance shared decision-making and perioperative preparedness.
Ribeiro et al. (Fri,) conducted a cohort in Gastrointestinal cancer (n=91,270). HOMEDAYS prediction model was evaluated on Days at home within 90 days after surgery (DAH-90). The HOMEDAYS prediction model accurately estimated median days at home within 90 days after elective gastrointestinal cancer surgery, demonstrating strong accuracy with a mean absolute error of 8.67.