Paul D Rozeboom1, Michael R Bronsert2, Catherine G Velopulos3, William G Henderson4, Kathryn L Colborn3, Karl E Hammermeister5, Anne Lambert-Kerzner2, Mark G Hall6, Robert C McIntyre7, Robert A Meguid8. 1. Department of Surgery, University of Colorado School of Medicine, Aurora, CO; Surgical Outcomes and Applied Research Program, University of Colorado School of Medicine, Aurora, CO. Electronic address: PAUL.ROZEBOOM@CUANSCHUTZ.EDU. 2. Surgical Outcomes and Applied Research Program, University of Colorado School of Medicine, Aurora, CO; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO. 3. Department of Surgery, University of Colorado School of Medicine, Aurora, CO; Surgical Outcomes and Applied Research Program, University of Colorado School of Medicine, Aurora, CO. 4. Surgical Outcomes and Applied Research Program, University of Colorado School of Medicine, Aurora, CO; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO; Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO. 5. Surgical Outcomes and Applied Research Program, University of Colorado School of Medicine, Aurora, CO; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO; Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO. 6. Department of Surgery, University of Colorado School of Medicine, Aurora, CO; University of Arkansas for Medical Sciences College of Medicine, Little Rock, AR. 7. Department of Surgery, University of Colorado School of Medicine, Aurora, CO. 8. Department of Surgery, University of Colorado School of Medicine, Aurora, CO; Surgical Outcomes and Applied Research Program, University of Colorado School of Medicine, Aurora, CO; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO.
Abstract
BACKGROUND: The Surgical Risk Preoperative Assessment System accurately predicts postoperative complications in elective surgery using only 8 preoperative variables, but its performance in emergency surgery has not been evaluated. We hypothesized that the Surgical Risk Preoperative Assessment System accurately predicts postoperative complications in emergency surgery and compared its performance to that of the American College of Surgeons Surgical Risk Calculator. METHODS: We calculated the Surgical Risk Preoperative Assessment System and the American College of Surgeons Surgical Risk Calculator risk estimates in a random sample of 1,010 emergency surgery cases from the American College of Surgeons National Surgical Quality Improvement Program 2014 to 2017 database. Risk estimates were compared with known outcomes. Analyses included the Hosmer-Lemeshow goodness of fit graphs and P values, c-indexes, and Brier scores. RESULTS: Results were similar between the Surgical Risk Preoperative Assessment System and the American College of Surgeons Surgical Risk Calculator for mortality, urinary tract infection, cardiac, venous thromboembolism, and renal complications. The American College of Surgeons Surgical Risk Calculator underestimated morbidity compared with the Surgical Risk Preoperative Assessment System (16.04% American College of Surgeons Surgical Risk Calculator vs 24.88% Surgical Risk Preoperative Assessment System vs 24.3% observed). Both calculators overestimated readmission (7.67% American College of Surgeons Surgical Risk Calculator vs 5.18% Surgical Risk Preoperative Assessment System vs 4.1% observed). CONCLUSION: Both calculators predicted mortality, urinary tract infection, cardiac, venous thromboembolism, and renal complications well, but readmissions relatively poorly. The Surgical Risk Preoperative Assessment System estimated overall morbidity accurately, while the American College of Surgeons Surgical Risk Calculator underestimated this risk.
BACKGROUND: The Surgical Risk Preoperative Assessment System accurately predicts postoperative complications in elective surgery using only 8 preoperative variables, but its performance in emergency surgery has not been evaluated. We hypothesized that the Surgical Risk Preoperative Assessment System accurately predicts postoperative complications in emergency surgery and compared its performance to that of the American College of Surgeons Surgical Risk Calculator. METHODS: We calculated the Surgical Risk Preoperative Assessment System and the American College of Surgeons Surgical Risk Calculator risk estimates in a random sample of 1,010 emergency surgery cases from the American College of Surgeons National Surgical Quality Improvement Program 2014 to 2017 database. Risk estimates were compared with known outcomes. Analyses included the Hosmer-Lemeshow goodness of fit graphs and P values, c-indexes, and Brier scores. RESULTS: Results were similar between the Surgical Risk Preoperative Assessment System and the American College of Surgeons Surgical Risk Calculator for mortality, urinary tract infection, cardiac, venous thromboembolism, and renal complications. The American College of Surgeons Surgical Risk Calculator underestimated morbidity compared with the Surgical Risk Preoperative Assessment System (16.04% American College of Surgeons Surgical Risk Calculator vs 24.88% Surgical Risk Preoperative Assessment System vs 24.3% observed). Both calculators overestimated readmission (7.67% American College of Surgeons Surgical Risk Calculator vs 5.18% Surgical Risk Preoperative Assessment System vs 4.1% observed). CONCLUSION: Both calculators predicted mortality, urinary tract infection, cardiac, venous thromboembolism, and renal complications well, but readmissions relatively poorly. The Surgical Risk Preoperative Assessment System estimated overall morbidity accurately, while the American College of Surgeons Surgical Risk Calculator underestimated this risk.
Authors: Nisha Pradhan; Adam R Dyas; Michael R Bronsert; Anne Lambert-Kerzner; William G Henderson; Howe Qiu; Kathryn L Colborn; Nicholas J Mason; Robert A Meguid Journal: Patient Saf Surg Date: 2022-03-17
Authors: Jianlin Shi; John F Hurdle; Stacy A Johnson; Jeffrey P Ferraro; David E Skarda; Samuel R G Finlayson; Matthew H Samore; Brian T Bucher Journal: Surgery Date: 2021-06-03 Impact factor: 4.348