Applying the National Surgical Quality Improvement Program Risk Calculator to Patients Undergoing Colorectal Surgery: Theory vs. Reality

Abstract Background Discussing potential morbidity and mortality is essential to informed decision-making and consent. The ACS NSQIP developed an online risk calculator (RC) using patient-specific information to determine operative risk. Study design Colorectal procedures at our independent academic...

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Bibliographic Details
Published in:The American journal of surgery 2017-01, Vol.213 (1), p.30-35
Main Authors: Adegboyega, Titilayo O., MD, Borgert, Andrew J., PhD, Lambert, Pamela J., BSN, RN, Jarman, Benjamin T., MD, FACS
Format: Article
Language:English
Subjects:
Accuracy
Adult
Aged
Aged, 80 and over
Chronic obstructive pulmonary disease
Colon - surgery
Colorectal surgery
Female
Health Status
Humans
Length of Stay
Male
Middle Aged
Morbidity
Mortality
National Surgical Quality Improvement Program
NSQIP risk calculator
Outcomes
Patients
Pneumonia
Postoperative Complications - epidemiology
Quality Improvement
Rectum - surgery
Risk Assessment
Statistical analysis
Surgery
Surgical complications
Surgical outcomes
Thrombosis
Urinary tract diseases
Urinary tract infections
Urogenital system
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Summary:Abstract Background Discussing potential morbidity and mortality is essential to informed decision-making and consent. The ACS NSQIP developed an online risk calculator (RC) using patient-specific information to determine operative risk. Study design Colorectal procedures at our independent academic medical center from 2010-2011 were evaluated. The RC’s predicted outcomes were compared to observed outcomes. Statistical analysis included Brier score, Wilcoxon sign rank test, and standardized event ratio (SER). Results There were 324 patients included. The RC’s Brier score was 0.24 (0.015-0.219) for predicting mortality and morbidity, respectively. The observed event rate for surgical site infection (SSI) and any complication was higher than the RC predicted (SER 1.9, CI [1.49, 2.39] and 1.39 CI [1.14, 1.68], respectively). The observed length of stay was longer than predicted (5.6 vs. 6.6 days, P
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2016.04.011