Does Work Relative Value Unit Measure Surgical Complexity for Risk Adjustment of Surgical Outcomes?

The purpose of this study was to determine whether the work relative value unit (workRVU) of a patient's operation can be useful as a measure of surgical complexity for the risk adjustment of surgical outcomes. We retrospectively analyzed the American College of Surgeon's National Surgical...

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Bibliographic Details
Published in:The Journal of surgical research 2023-07, Vol.287, p.176-185
Main Authors: Dyas, Adam R., Meguid, Robert A., Bronsert, Michael R., Madsen, Helen J., Colborn, Kathryn L., Lambert-Kerzner, Anne, Henderson, William G.
Format: Article
Language:English
Subjects:
ACS-NSQIP
Humans
Neurosurgical Procedures - adverse effects
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Postoperative outcomes
Quality Improvement
Retrospective Studies
Risk Adjustment
Risk Factors
Surgical complexity
Surgical outcomes
Treatment Outcome
United States
WorkRVU
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Summary:The purpose of this study was to determine whether the work relative value unit (workRVU) of a patient's operation can be useful as a measure of surgical complexity for the risk adjustment of surgical outcomes. We retrospectively analyzed the American College of Surgeon's National Surgical Quality Improvement Program database (2005-2018). We examined the associations of workRVU of the patient's primary operation with preoperative patient characteristics and associations with postoperative complications. We performed forward selection multiple logistic regression analysis to determine the predictive importance of workRVU. We then generated prediction models using patient characteristics with and without workRVU and compared c-indexes to assess workRVU's additive predictive value. 7,507,991 operations were included. Patients who were underweight, functionally dependent, transferred from an acute care hospital, had higher American Society of Anesthesiologists class or who had medical comorbidities had operations with higher workRVU (all P 
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2023.02.001