Key result
Predictive models for surgical outcomes excluding laboratory data achieved similar predictive accuracy for 30-day morbidity and mortality compared to models including laboratory data.
Why the study?
Does the exclusion of laboratory data reduce the predictive accuracy of models for 30-day surgical morbidity and mortality?
Observational
Yes
Does the exclusion of laboratory data reduce the predictive accuracy of models for 30-day surgical morbidity and mortality?
Models developed to predict surgical outcomes can achieve similar predictive accuracy without the inclusion of laboratory data.
Supports omitting labs from surgical risk models without accuracy loss; hypothesis-generating, needs prospective validation before practice change.
Studies have demonstrated that predictive accuracy of acuity models flattens when more than 10 variables are used. The authors hypothesized that the exclusion of laboratory data would produce a reliable predictive model. The American College of Surgeons National Surgical Quality Improvement Program data set from 2005 to 2008 was reviewed. Logistic regression was used to develop models from 86 preoperative variables to predict 30-day morbidity and mortality. Models were compared by measuring area under the receiver operating characteristic (AUROC) values that then were analyzed with unpaired t test. As the number of variables decreased, the change in the AUROC for mortality and morbidity were not statistically significant for 10- and 5-variable models. Although the AUROC for acuity models decreased slightly for morbidity and mortality when laboratory values were excluded, these changes were not statistically significant. This study shows that models developed to predict surgical outcomes can achieve similar predictive accuracy without laboratory data.
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Tsiouris et al. (2013) conducted an observational in Surgical risk. Predictive models excluding laboratory data vs. Predictive models including laboratory data was evaluated on 30-day morbidity and mortality (p=not statistically significant). Predictive models for surgical outcomes excluding laboratory data achieved similar predictive accuracy for 30-day morbidity and mortality compared to models including laboratory data.
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