TY - JOUR
T1 - A novel online calculator predicting short-term postoperative outcomes in patients with metastatic brain tumors
AU - Khalafallah, Adham M.
AU - Jimenez, Adrian E.
AU - Patel, Palak
AU - Huq, Sakibul
AU - Azmeh, Omar
AU - Mukherjee, Debraj
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Purpose: Establishing predictors of hospital length of stay (LOS), discharge deposition, and total hospital charges is essential to providing high-quality, value-based care. Though previous research has investigated these outcomes for patients with metastatic brain tumors, there are currently no tools that synthesize such research findings and allow for prediction of these outcomes on a patient-by-patient basis. The present study sought to develop a prediction calculator that uses patient demographic and clinical information to predict extended hospital length of stay, non-routine discharge disposition, and high total hospital charges for patients with metastatic brain tumors. Methods: Patients undergoing surgery for metastatic brain tumors at a single academic institution were analyzed (2017–2019). Multivariate logistic regression was used to identify independent predictors of extended LOS (> 7 days), non-routine discharge, and high total hospital charges (> $ 46,082.63). p < 0.05 was considered statistically significant. C-statistics and the Hosmer–Lemeshow test were used to assess model discrimination and calibration, respectively. Results: A total of 235 patients were included in our analysis, with a mean age of 62.74 years. The majority of patients were female (52.3%) and Caucasian (76.6%). Our models predicting extended LOS, non-routine discharge, and high hospital charges had optimism-corrected c-statistics > 0.7, and all three models demonstrated adequate calibration (p > 0.05). The final models are available as an online calculator (https://neurooncsurgery.shinyapps.io/brain_mets_calculator/). Conclusions: Our models predicting postoperative outcomes allow for individualized risk-estimation for patients following surgery for metastatic brain tumors. Our results may be useful in helping clinicians to provide resource-conscious, high-value care.
AB - Purpose: Establishing predictors of hospital length of stay (LOS), discharge deposition, and total hospital charges is essential to providing high-quality, value-based care. Though previous research has investigated these outcomes for patients with metastatic brain tumors, there are currently no tools that synthesize such research findings and allow for prediction of these outcomes on a patient-by-patient basis. The present study sought to develop a prediction calculator that uses patient demographic and clinical information to predict extended hospital length of stay, non-routine discharge disposition, and high total hospital charges for patients with metastatic brain tumors. Methods: Patients undergoing surgery for metastatic brain tumors at a single academic institution were analyzed (2017–2019). Multivariate logistic regression was used to identify independent predictors of extended LOS (> 7 days), non-routine discharge, and high total hospital charges (> $ 46,082.63). p < 0.05 was considered statistically significant. C-statistics and the Hosmer–Lemeshow test were used to assess model discrimination and calibration, respectively. Results: A total of 235 patients were included in our analysis, with a mean age of 62.74 years. The majority of patients were female (52.3%) and Caucasian (76.6%). Our models predicting extended LOS, non-routine discharge, and high hospital charges had optimism-corrected c-statistics > 0.7, and all three models demonstrated adequate calibration (p > 0.05). The final models are available as an online calculator (https://neurooncsurgery.shinyapps.io/brain_mets_calculator/). Conclusions: Our models predicting postoperative outcomes allow for individualized risk-estimation for patients following surgery for metastatic brain tumors. Our results may be useful in helping clinicians to provide resource-conscious, high-value care.
KW - Brain tumor
KW - Neuro-oncology
KW - Outcomes
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U2 - 10.1007/s11060-020-03626-1
DO - 10.1007/s11060-020-03626-1
M3 - Article
C2 - 32964354
AN - SCOPUS:85091366664
SN - 0167-594X
VL - 149
SP - 429
EP - 436
JO - Journal of neuro-oncology
JF - Journal of neuro-oncology
IS - 3
ER -