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Evaluating the American College of Surgeons National Surgical Quality Improvement project risk calculator: results from the U.S. Extrahepatic Biliary Malignancy Consortium. HPB (Oxford) 2017 12;19(12):1104-1111

Date

09/12/2017

Pubmed ID

28890310

Pubmed Central ID

PMC5915623

DOI

10.1016/j.hpb.2017.08.009

Scopus ID

2-s2.0-85035778687   9 Citations

Abstract

BACKGROUND: The objective of this study is to evaluate use of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) online risk calculator for estimating common outcomes after operations for gallbladder cancer and extrahepatic cholangiocarcinoma.

METHODS: Subjects from the United States Extrahepatic Biliary Malignancy Consortium (USE-BMC) who underwent operation between January 1, 2000 and December 31, 2014 at 10 academic medical centers were included in this study. Calculator estimates of risk were compared to actual outcomes.

RESULTS: The majority of patients underwent partial or major hepatectomy, Whipple procedures or extrahepatic bile duct resection. For the entire cohort, c-statistics for surgical site infection (0.635), reoperation (0.680) and readmission (0.565) were less than 0.7. The c-statistic for death was 0.740. For all outcomes the actual proportion of patients experiencing an event was much higher than the median predicted risk of that event. Similarly, the group of patients who experienced an outcome did have higher median predicted risk than those who did not.

CONCLUSIONS: The ACS NSQIP risk calculator is easy to use but requires further modifications to more accurately estimate outcomes for some patient populations and operations for which validation studies show suboptimal performance.

Author List

Beal EW, Lyon E, Kearney J, Wei L, Ethun CG, Black SM, Dillhoff M, Salem A, Weber SM, Tran TB, Poultsides G, Shenoy R, Hatzaras I, Krasnick B, Fields RC, Buttner S, Scoggins CR, Martin RCG, Isom CA, Idrees K, Mogal HD, Shen P, Maithel SK, Pawlik TM, Schmidt CR

Author

Harveshp Mogal MD Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Academic Medical Centers
Adult
Aged
Aged, 80 and over
Area Under Curve
Bile Duct Neoplasms
Biliary Tract Surgical Procedures
Cholangiocarcinoma
Databases, Factual
Decision Support Techniques
Female
Gallbladder Neoplasms
Hepatectomy
Humans
Male
Middle Aged
Pancreaticoduodenectomy
Patient Readmission
Postoperative Complications
Predictive Value of Tests
ROC Curve
Reoperation
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
United States
Young Adult
jenkins-FCD Prod-411 e00897e83867fcfa48419861683711f8d99adb75