Akademik Veri Yönetim Sistemi
International Journal of Gynecological Cancer, 2026 (SCI-Expanded, Scopus)
Objective: This study aimed to assess the predictive performance of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator in estimating 30-day post-operative complications and mortality among patients undergoing elective gynecologic oncology surgery. Methods: This single-center retrospective cohort study included 789 patients who underwent elective gynecologic oncology surgery at a tertiary center between January 2016 and February 2025. Pre-operative data for 19 risk factors included in the ACS NSQIP calculator were extracted from patient records. Individual complication risks were calculated and compared with actual post-operative outcomes using binary logistic regression analysis, receiver operating characteristic curve analysis, and the Brier score. Results: Severe complications, defined on the basis of ACS NSQIP composite criteria, occurred in 6.5% of patients, while “any complication” was observed in 10.1%. The ACS NSQIP model demonstrated excellent predictive performance for mortality (area under the curve [AUC] = 0.965, Brier = 0.006), good performance for cardiac complications (AUC = 0.885), although calibration was moderate (Brier = 0.077), and acceptable performance for venous thromboembolism (AUC = 0.789, Brier = 0.006). The model showed acceptable discrimination and calibration for serious complications (AUC = 0.701, Brier = 0.057), whereas predictive accuracy for “any complication” was fair but statistically significant (AUC = 0.657, Brier = 0.086). Acceptable discriminatory performance was also observed for surgical site infection (AUC = 0.776, Brier = 0.037) and re-operation (AUC = 0.725, Brier = 0.011). In contrast, despite moderate AUC values, predictive performance for renal failure and pneumonia was limited, as associations were not statistically significant in logistic regression analyses. The model performed poorly for sepsis, urinary tract infection, and re-admission. Conclusions: The ACS NSQIP Surgical Risk Calculator provides a clinically applicable tool for pre-operative risk assessment in gynecologic oncology surgery, particularly for predicting mortality and selected systemic complications, including cardiac events and venous thromboembolism.