OBJECTIVES: The National Surgical Quality Improvement Program is aimed at preventing perioperative complications. An online calculator was recently published, but the primary studies used limited gynecologic surgery data. The purpose of this study was to evaluate the performance of the National Surgical Quality Improvement Program Universal Surgical Risk Calculator (URC) on the patients of a gynecologic oncology service. STUDY DESIGN: We reviewed 628 consecutive surgeries performed by our gynecologic oncology service between July 2012 and June 2013. Demographic data including diagnosis and cancer stage, if applicable, were collected. Charts were reviewed to determine complication rates. Specific complications were as follows: death, pneumonia, cardiac complications, surgical site infection (SSI) or urinary tract infection, renal failure, or venous thromboembolic event. Data were compared with modeled outcomes using Brier scores and receiver operating characteristic curves. Significance was declared based on P < 0.05. RESULTS: The model accurately predicated death and venous thromboembolic event, with Brier scores of 0.004 and 0.003, respectively. Predicted risk was 50% greater than experienced for urinary tract infection; the experienced SSI and pneumonia rates were 43% and 36% greater than predicted. For any complication, the Brier score 0.023 indicates poor performance of the model. CONCLUSIONS: In this study of gynecologic surgeries, we could not verify the predictive value of the URC for cardiac complications, SSI, and pneumonia. One disadvantage of applying a URC to multiple subspecialties is that with some categories, complications are not accurately estimated. Our data demonstrate that some predicted risks reported by the calculator need to be interpreted with reservation.
OBJECTIVES: The National Surgical Quality Improvement Program is aimed at preventing perioperative complications. An online calculator was recently published, but the primary studies used limited gynecologic surgery data. The purpose of this study was to evaluate the performance of the National Surgical Quality Improvement Program Universal Surgical Risk Calculator (URC) on the patients of a gynecologic oncology service. STUDY DESIGN: We reviewed 628 consecutive surgeries performed by our gynecologic oncology service between July 2012 and June 2013. Demographic data including diagnosis and cancer stage, if applicable, were collected. Charts were reviewed to determine complication rates. Specific complications were as follows: death, pneumonia, cardiac complications, surgical site infection (SSI) or urinary tract infection, renal failure, or venous thromboembolic event. Data were compared with modeled outcomes using Brier scores and receiver operating characteristic curves. Significance was declared based on P < 0.05. RESULTS: The model accurately predicated death and venous thromboembolic event, with Brier scores of 0.004 and 0.003, respectively. Predicted risk was 50% greater than experienced for urinary tract infection; the experienced SSI and pneumonia rates were 43% and 36% greater than predicted. For any complication, the Brier score 0.023 indicates poor performance of the model. CONCLUSIONS: In this study of gynecologic surgeries, we could not verify the predictive value of the URC for cardiac complications, SSI, and pneumonia. One disadvantage of applying a URC to multiple subspecialties is that with some categories, complications are not accurately estimated. Our data demonstrate that some predicted risks reported by the calculator need to be interpreted with reservation.
Authors: Purvi Parikh; Mira Shiloach; Mark E Cohen; Karl Y Bilimoria; Clifford Y Ko; Bruce L Hall; Henry A Pitt Journal: HPB (Oxford) Date: 2010-09 Impact factor: 3.647
Authors: Prateek K Gupta; Himani Gupta; Abhishek Sundaram; Manu Kaushik; Xiang Fang; Weldon J Miller; Dennis J Esterbrooks; Claire B Hunter; Iraklis I Pipinos; Jason M Johanning; Thomas G Lynch; R Armour Forse; Syed M Mohiuddin; Aryan N Mooss Journal: Circulation Date: 2011-07-05 Impact factor: 29.690
Authors: Karl Y Bilimoria; Yaoming Liu; Jennifer L Paruch; Lynn Zhou; Thomas E Kmiecik; Clifford Y Ko; Mark E Cohen Journal: J Am Coll Surg Date: 2013-09-18 Impact factor: 6.113
Authors: David E Cohn; Mario Leitao; Charles Levenback; Ross Berkowitz; Lynda Roman; Joseph Lucci; Sarah Kim; Johnathon Lancaster; Kunle Odunsi; Mark Wakabayashi; Barbara A Goff Journal: Gynecol Oncol Date: 2013-05-26 Impact factor: 5.482
Authors: Justin B Dimick; Steven L Chen; Paul A Taheri; William G Henderson; Shukri F Khuri; Darrell A Campbell Journal: J Am Coll Surg Date: 2004-10 Impact factor: 6.113
Authors: Shitanshu Uppal; Ahmed Al-Niaimi; Laurel W Rice; Stephen L Rose; David M Kushner; Ryan J Spencer; Ellen Hartenbach Journal: Gynecol Oncol Date: 2013-08-17 Impact factor: 5.482
Authors: Margaret A Olsen; James Higham-Kessler; Deborah S Yokoe; Anne M Butler; Johanna Vostok; Kurt B Stevenson; Yosef Khan; Victoria J Fraser Journal: Infect Control Hosp Epidemiol Date: 2009-11 Impact factor: 3.254
Authors: Stephanie Cham; Ling Chen; Caryn M St Clair; June Y Hou; Ana I Tergas; Alexander Melamed; Cande V Ananth; Alfred I Neugut; Dawn L Hershman; Jason D Wright Journal: Am J Obstet Gynecol Date: 2019-02-13 Impact factor: 8.661