Predicting Postoperative Complications for Acute Care Surgery Patients Using the ACS NSQIP Surgical Risk Calculator
| Autor: | Travis M. Polk, Rebecca C. Britt, Benjamin Smith, Jessica R Burgess, Leonard J. Weireter |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
education.field_of_study business.industry medicine.medical_treatment Urinary system Population MEDLINE 030208 emergency & critical care medicine Retrospective cohort study General Medicine medicine.disease 03 medical and health sciences Pneumonia 0302 clinical medicine 030220 oncology & carcinogenesis Laparotomy Acute care Emergency medicine medicine Risk assessment education business |
| Zdroj: | The American Surgeon. 83:733-738 |
| ISSN: | 1555-9823 0003-1348 |
| Popis: | The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator has been used to assist surgeons in predicting the risk of postoperative complications. This study aims to determine if the risk calculator accurately predicts complications in acute care surgical patients undergoing laparotomy. A retrospective review was performed on all patients on the acute care surgery service at a tertiary hospital who underwent laparotomy between 2011 and 2012. The preoperative risk factors were used to calculate the estimated risks of postoperative complications in both the original ACS NSQIP calculator and updated calculator (June 2016). The predicted rate of complications was then compared with the actual rate of complications. Ninety-five patients were included. Both risk calculators accurately predicted the risk of pneumonia, cardiac complications, urinary tract infections, venous thromboembolism, renal failure, unplanned returns to operating room, discharge to nursing facility, and mortality. Both calculators underestimated serious complications (26% vs 39%), overall complications (32.4% vs 45.3%), surgical site infections (9.3% vs 20%), and length of stay (9.7 days versus 13.1 days). When patients with prolonged hospitalization were excluded, the updated calculator accurately predicted length of stay. The ACS NSQIP risk calculator underestimates the overall risk of complications, surgical infections, and length of stay. The updated calculator accurately predicts length of stay for patients |
| Databáze: | OpenAIRE |
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