Apeksha Dave1, Eliza W Beal1, Alexandra G Lopez-Aguiar2, George Poultsides3, Eleftherios Makris3, Flavio G Rocha4, Zaheer Kanji4, Sean Ronnekleiv-Kelly5, Victoria R Rendell5, Ryan C Fields6, Bradley A Krasnick6, Kamran Idrees7, Paula Marincola Smith7, Hari Nathan8, Megan Beems8, Shishir K Maithel2, Timothy M Pawlik1, Carl R Schmidt1, Mary E Dillhoff9,10. 1. Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. 2. Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA. 3. Department of Surgery, Stanford University, Palo Alto, CA, USA. 4. Department of Surgery, Virginia Mason Medical Center, Seattle, WA, USA. 5. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 6. Department of Surgery, Washington University School of Medicine, St. Louis, MI, USA. 7. Division of Surgical Oncology, Department of Surgery, Vanderbilt University, Nashville, TN, USA. 8. Division of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA. 9. Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. Mary.Dillhoff@osumc.edu. 10. Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, 320 W. 10th Ave, M256 Starling Loving Hall, Columbus, OH, 43210-1267, USA. Mary.Dillhoff@osumc.edu.
Abstract
BACKGROUND: In a changing health care environment where patient outcomes will be more closely scrutinized, the ability to predict surgical complications is becoming increasingly important. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) online risk calculator is a popular tool to predict surgical risk. This paper aims to assess the applicability of the ACS NSQIP calculator to patients undergoing surgery for pancreatic neuroendocrine tumors (PNETs). METHODS: Using the US Neuroendocrine Tumor Study Group (USNET-SG), 890 patients who underwent pancreatic procedures between 1/1/2000-12/31/2016 were evaluated. Predicted and actual outcomes were compared using C-statistics and Brier scores. RESULTS: The most commonly performed procedure was distal pancreatectomy, followed by standard and pylorus-preserving pancreaticoduodenectomy. For the entire group of patients studied, C-statistics were highest for discharge destination (0.79) and cardiac complications (0.71), and less than 0.7 for all other complications. The Brier scores for surgical site infection (0.1441) and discharge to nursing/rehabilitation facility (0.0279) were below the Brier score cut-off, while the rest were equal to or above and therefore not useful for interpretation. CONCLUSION: This work indicates that the ACS NSQIP risk calculator is a valuable tool that should be used with caution and in coordination with clinical assessment for PNET clinical decision-making.
BACKGROUND: In a changing health care environment where patient outcomes will be more closely scrutinized, the ability to predict surgical complications is becoming increasingly important. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) online risk calculator is a popular tool to predict surgical risk. This paper aims to assess the applicability of the ACS NSQIP calculator to patients undergoing surgery for pancreatic neuroendocrine tumors (PNETs). METHODS: Using the US Neuroendocrine Tumor Study Group (USNET-SG), 890 patients who underwent pancreatic procedures between 1/1/2000-12/31/2016 were evaluated. Predicted and actual outcomes were compared using C-statistics and Brier scores. RESULTS: The most commonly performed procedure was distal pancreatectomy, followed by standard and pylorus-preserving pancreaticoduodenectomy. For the entire group of patients studied, C-statistics were highest for discharge destination (0.79) and cardiac complications (0.71), and less than 0.7 for all other complications. The Brier scores for surgical site infection (0.1441) and discharge to nursing/rehabilitation facility (0.0279) were below the Brier score cut-off, while the rest were equal to or above and therefore not useful for interpretation. CONCLUSION: This work indicates that the ACS NSQIP risk calculator is a valuable tool that should be used with caution and in coordination with clinical assessment for PNET clinical decision-making.
Authors: T H Lee; E R Marcantonio; C M Mangione; E J Thomas; C A Polanczyk; E F Cook; D J Sugarbaker; M C Donaldson; R Poss; K K Ho; L E Ludwig; A Pedan; L Goldman Journal: Circulation Date: 1999-09-07 Impact factor: 29.690
Authors: Peter J Kneuertz; Henry A Pitt; Karl Y Bilimoria; Jill P Smiley; Mark E Cohen; Clifford Y Ko; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2012-07-04 Impact factor: 3.452
Authors: L Goldman; D L Caldera; S R Nussbaum; F S Southwick; D Krogstad; B Murray; D S Burke; T A O'Malley; A H Goroll; C H Caplan; J Nolan; B Carabello; E E Slater Journal: N Engl J Med Date: 1977-10-20 Impact factor: 91.245
Authors: Ryan P Merkow; Bruce L Hall; Mark E Cohen; Justin B Dimick; Edward Wang; Warren B Chow; Clifford Y Ko; Karl Y Bilimoria Journal: J Am Coll Surg Date: 2012-03-21 Impact factor: 6.113
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: Shay Golan; Melanie A Adamsky; Scott C Johnson; Nimrod S Barashi; Zachary L Smith; Maria V Rodriguez; Chuanhong Liao; Norm D Smith; Gary D Steinberg; Arieh L Shalhav Journal: Urol Oncol Date: 2017-10-13 Impact factor: 3.498
Authors: James T McPhee; Joshua S Hill; Giles F Whalen; Maksim Zayaruzny; Demetrius E Litwin; Mary E Sullivan; Frederick A Anderson; Jennifer F Tseng Journal: Ann Surg Date: 2007-08 Impact factor: 12.969
Authors: Yael Vin; Camelia S Sima; George I Getrajdman; Karen T Brown; Anne Covey; Murray F Brennan; Peter J Allen Journal: J Am Coll Surg Date: 2008-06-30 Impact factor: 6.113
Authors: Patrick B Schwartz; Christopher C Stahl; Cecilia Ethun; Nicholas Marka; George A Poultsides; Kevin K Roggin; Ryan C Fields; John H Howard; Callisia N Clarke; Konstantinos I Votanopoulos; Kenneth Cardona; Daniel E Abbott Journal: J Surg Oncol Date: 2020-06-17 Impact factor: 3.454
Authors: Neel Chudgar; Shi Yan; Meier Hsu; Kay See Tan; Katherine D Gray; Daniela Molena; David R Jones; Valerie W Rusch; Gaetano Rocco; James M Isbell Journal: J Thorac Cardiovasc Surg Date: 2021-01-21 Impact factor: 5.209