Register-based algorithm to detect post-operative complications in patients with ovarian cancer

Jakob Ohm Oreskov; Cecilie Nørregaard Albertsen; Claus Høgdall; Anne Weng Ekmann-Gade; Sarah Mejer Sørensen; Karsten Dromph; Algirdas Markauskas; Pernille Tine Jensen; Tine Henrichsen Schnack

doi:10.61409/A12240907

Register-based algorithm to detect post-operative complications in patients with ovarian cancer

Jakob Ohm Oreskov^*, Cecilie Nørregaard Albertsen, Claus Høgdall, Anne Weng Ekmann-Gade, Sarah Mejer Sørensen, Karsten Dromph, Algirdas Markauskas, Pernille Tine Jensen, Tine Henrichsen Schnack

^*Corresponding author for this work

Abstract

INTRODUCTION: Epithelial ovarian cancer (OC) is the most fatal gynaecological cancer. The use of extensive surgical procedures implies the potential severity of post-operative complications. In Denmark, registration of complications has changed from manual database registration to data transfer from medical records to the Danish National Patient Registry (NPR). This study examines whether a new complication algorithm based on NPR data may be used to identify 30-day post-operative complications among patients with advanced stage IIIC-IV OC.

METHODS: Complications were graded according to Clavien-Dindo (CD). The algorithm was validated in a cohort undergoing surgery at the OUH, between 1 January 2007 and 31 December 2012. The CD grades were sub-grouped into mild (CD 0-2) and severe (CD 3-5) complications for sub-analyses.

RESULTS: A total of 330 patients were included. The overall sensitivity (SN) and specificity (SP) of the algorithm (CD 0-5) were 56.4% (95% confidence interval (CI): 48.0-65.0%) and 92.4% (95% CI: 86.5-93.0%), respectively, with an overall kappa coefficient (κ) of 0.43. For severe complications (CD 3-5), the algorithm had an SN of 74.2% (95% CI: 67.4-83.6%) and an SP of 97.4% (95% CI: 95.5-99.4%), with a κ of 0.65.

CONCLUSIONS: The algorithm had a moderate SN and a high SP with substantial agreement regarding severe complications. A standardised registration of complications in the NPR will likely improve the algorithm's performance.

FUNDING: The Danish Clinical Quality Program DKK 200,000.

TRIAL REGISTRATION: Not relevant.

Original language	English
Article number	A12240907
Journal	Danish Medical Journal
Volume	72
Issue number	7
ISSN	1603-9629
DOIs	https://doi.org/10.61409/A12240907
Publication status	Published - 26 May 2025

Keywords

Humans
Female
Algorithms
Ovarian Neoplasms/surgery
Registries
Postoperative Complications/epidemiology
Denmark/epidemiology
Middle Aged
Aged
Adult
Sensitivity and Specificity
Carcinoma, Ovarian Epithelial/surgery
Aged, 80 and over

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10.61409/A12240907Licence: CC BY-NC-ND

Cite this

@article{097c717d122c4c53a45e31e615f1cf65,

title = "Register-based algorithm to detect post-operative complications in patients with ovarian cancer",

abstract = "INTRODUCTION: Epithelial ovarian cancer (OC) is the most fatal gynaecological cancer. The use of extensive surgical procedures implies the potential severity of post-operative complications. In Denmark, registration of complications has changed from manual database registration to data transfer from medical records to the Danish National Patient Registry (NPR). This study examines whether a new complication algorithm based on NPR data may be used to identify 30-day post-operative complications among patients with advanced stage IIIC-IV OC.METHODS: Complications were graded according to Clavien-Dindo (CD). The algorithm was validated in a cohort undergoing surgery at the OUH, between 1 January 2007 and 31 December 2012. The CD grades were sub-grouped into mild (CD 0-2) and severe (CD 3-5) complications for sub-analyses.RESULTS: A total of 330 patients were included. The overall sensitivity (SN) and specificity (SP) of the algorithm (CD 0-5) were 56.4\% (95\% confidence interval (CI): 48.0-65.0\%) and 92.4\% (95\% CI: 86.5-93.0\%), respectively, with an overall kappa coefficient (κ) of 0.43. For severe complications (CD 3-5), the algorithm had an SN of 74.2\% (95\% CI: 67.4-83.6\%) and an SP of 97.4\% (95\% CI: 95.5-99.4\%), with a κ of 0.65.CONCLUSIONS: The algorithm had a moderate SN and a high SP with substantial agreement regarding severe complications. A standardised registration of complications in the NPR will likely improve the algorithm's performance.FUNDING: The Danish Clinical Quality Program DKK 200,000.TRIAL REGISTRATION: Not relevant.",

keywords = "Humans, Female, Algorithms, Ovarian Neoplasms/surgery, Registries, Postoperative Complications/epidemiology, Denmark/epidemiology, Middle Aged, Aged, Adult, Sensitivity and Specificity, Carcinoma, Ovarian Epithelial/surgery, Aged, 80 and over",

author = "Oreskov, \{Jakob Ohm\} and Albertsen, \{Cecilie N{\o}rregaard\} and Claus H{\o}gdall and Ekmann-Gade, \{Anne Weng\} and S{\o}rensen, \{Sarah Mejer\} and Karsten Dromph and Algirdas Markauskas and Jensen, \{Pernille Tine\} and Schnack, \{Tine Henrichsen\}",

note = "Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.",

year = "2025",

month = may,

day = "26",

doi = "10.61409/A12240907",

language = "English",

volume = "72",

journal = "Danish Medical Journal",

issn = "1603-9629",

publisher = "Almindelige Danske Laegeforening",

number = "7",

}

TY - JOUR

T1 - Register-based algorithm to detect post-operative complications in patients with ovarian cancer

AU - Oreskov, Jakob Ohm

AU - Albertsen, Cecilie Nørregaard

AU - Høgdall, Claus

AU - Ekmann-Gade, Anne Weng

AU - Sørensen, Sarah Mejer

AU - Dromph, Karsten

AU - Markauskas, Algirdas

AU - Jensen, Pernille Tine

AU - Schnack, Tine Henrichsen

N1 - Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.

PY - 2025/5/26

Y1 - 2025/5/26

N2 - INTRODUCTION: Epithelial ovarian cancer (OC) is the most fatal gynaecological cancer. The use of extensive surgical procedures implies the potential severity of post-operative complications. In Denmark, registration of complications has changed from manual database registration to data transfer from medical records to the Danish National Patient Registry (NPR). This study examines whether a new complication algorithm based on NPR data may be used to identify 30-day post-operative complications among patients with advanced stage IIIC-IV OC.METHODS: Complications were graded according to Clavien-Dindo (CD). The algorithm was validated in a cohort undergoing surgery at the OUH, between 1 January 2007 and 31 December 2012. The CD grades were sub-grouped into mild (CD 0-2) and severe (CD 3-5) complications for sub-analyses.RESULTS: A total of 330 patients were included. The overall sensitivity (SN) and specificity (SP) of the algorithm (CD 0-5) were 56.4% (95% confidence interval (CI): 48.0-65.0%) and 92.4% (95% CI: 86.5-93.0%), respectively, with an overall kappa coefficient (κ) of 0.43. For severe complications (CD 3-5), the algorithm had an SN of 74.2% (95% CI: 67.4-83.6%) and an SP of 97.4% (95% CI: 95.5-99.4%), with a κ of 0.65.CONCLUSIONS: The algorithm had a moderate SN and a high SP with substantial agreement regarding severe complications. A standardised registration of complications in the NPR will likely improve the algorithm's performance.FUNDING: The Danish Clinical Quality Program DKK 200,000.TRIAL REGISTRATION: Not relevant.

AB - INTRODUCTION: Epithelial ovarian cancer (OC) is the most fatal gynaecological cancer. The use of extensive surgical procedures implies the potential severity of post-operative complications. In Denmark, registration of complications has changed from manual database registration to data transfer from medical records to the Danish National Patient Registry (NPR). This study examines whether a new complication algorithm based on NPR data may be used to identify 30-day post-operative complications among patients with advanced stage IIIC-IV OC.METHODS: Complications were graded according to Clavien-Dindo (CD). The algorithm was validated in a cohort undergoing surgery at the OUH, between 1 January 2007 and 31 December 2012. The CD grades were sub-grouped into mild (CD 0-2) and severe (CD 3-5) complications for sub-analyses.RESULTS: A total of 330 patients were included. The overall sensitivity (SN) and specificity (SP) of the algorithm (CD 0-5) were 56.4% (95% confidence interval (CI): 48.0-65.0%) and 92.4% (95% CI: 86.5-93.0%), respectively, with an overall kappa coefficient (κ) of 0.43. For severe complications (CD 3-5), the algorithm had an SN of 74.2% (95% CI: 67.4-83.6%) and an SP of 97.4% (95% CI: 95.5-99.4%), with a κ of 0.65.CONCLUSIONS: The algorithm had a moderate SN and a high SP with substantial agreement regarding severe complications. A standardised registration of complications in the NPR will likely improve the algorithm's performance.FUNDING: The Danish Clinical Quality Program DKK 200,000.TRIAL REGISTRATION: Not relevant.

KW - Humans

KW - Female

KW - Algorithms

KW - Ovarian Neoplasms/surgery

KW - Registries

KW - Postoperative Complications/epidemiology

KW - Denmark/epidemiology

KW - Middle Aged

KW - Aged

KW - Adult

KW - Sensitivity and Specificity

KW - Carcinoma, Ovarian Epithelial/surgery

KW - Aged, 80 and over

UR - https://www.scopus.com/pages/publications/105010289296

U2 - 10.61409/A12240907

DO - 10.61409/A12240907

M3 - Journal article

C2 - 40600683

SN - 1603-9629

VL - 72

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 7

M1 - A12240907

ER -

Register-based algorithm to detect post-operative complications in patients with ovarian cancer

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Keywords

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