Article Text
Abstract
Objectives Increase in the incidence of gynaecological cancers has resulted in increased operations, specifically in patients with multiple comorbidities. This is often associated with higher rates of postoperative mortality and morbidity and presents a challenge with an unmet need for an accurate, personalised risk prediction. DASI is a self-reported 12 item scale questionnaire based around commonly performed activities of daily living. This study investigates the accuracy of DASI in preoperative prediction of postoperative outcomes in gynaeoncology.
Methods A retrospective cohort study of 330 patients who had undergone an operative treatment. All patients had completed the DASI questionnaire prior to their consultation. Actual postoperative 30 day complications and the length of stay recorded. DASI was then compared with the occurrence of postoperative complications.
Results 181 patients underwent robotic procedure, 37 - laparoscopic and 112 - open surgery. Our results showed that the higher DASI score the less likely patients were to have postoperative complications. This result was statistically significant with odds ratio of 0.974 and confidence interval between 0.958 and 0.991. We were also able to demonstrate that for every 10 points further up the DASI score a patient was 0.768 times less likely to have a postoperative complication. Hence general morbidity prediction of DASI score has been found to statistically significantly predict postoperative complications (AUC-0.700).
Conclusions Our study has shown that DASI score is a useful predictive tool of perioperative estimation of postoperative complications in gynaeoncology. Further analysis with a larger sample size and a multicentre prospective study is currently underway to validate the findings.