The Effect of Body Mass Index on Perioperative Outcomes After Major Surgery: Results from the National Surgical Quality Improvement Program (ACS-NSQIP) 2005–2011

2015 ◽  
Vol 39 (10) ◽  
pp. 2376-2385 ◽  
Author(s):  
Akshay Sood ◽  
Firas Abdollah ◽  
Jesse D. Sammon ◽  
Kaustav Majumder ◽  
Marianne Schmid ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Quality Improvement ◽  
Body Mass ◽  
Quality Improvement Program ◽  
Perioperative Outcomes ◽  
Major Surgery ◽  
Improvement Program ◽  
Surgical Quality ◽  
Acs Nsqip

Economic impact of the use of the National Surgical Quality Improvement Program

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Alvine Fansi ◽  
Angela Ly ◽  
Julie Mayrand ◽  
Maggy Wassef ◽  
Aldanie Rho ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Cost Analysis ◽  
Economic Impact ◽  
Quality Improvement Program ◽  
Economic Evaluations ◽  
Complication Rates ◽  
Improvement Program ◽  
Surgical Quality ◽  
Acs Nsqip ◽  
The Cost

Objectives The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) is a validated, risk-adjusted database for improving the quality and security of surgical care. ACS NSQIP can help participating hospitals target areas that need improvement. The aim of this study was to systematically review the literature analyzing the economic impact of using NSQIP. This paper also provides an estimation of annual cost savings following the implementation of NSQIP and quality improvement (QI) activities in two hospitals in Quebec. Methods In June 2018, we searched in seven databases, including PubMed, Embase, and NHSEED for economic evaluations based on NSQIP data. Contextual NSQIP databases from two hospitals were collected and analyzed. A cost analysis was conducted from the hospital care perspective, comparing complication costs before and after 1 year of the implementation of NSQIP and QI activities. The number and the cost of complications are measured. Costs are presented in 2018 Canadian dollars. Results Out of 1,612 studies, 11 were selected. The level of overall evidence was judged to be of moderate to high quality. In general, data showed that, following the implementation of NSQIP and QI activities, a significant decrease in complications and associated costs was observed, which improved with time. In the cost analysis of contextual data, the reduction in complication costs outweighed the cost of implementing NSQIP. However, this cost analysis did not take into account the costs of QI activities. Conclusions NSQIP improves complication rates and associated costs when QI activities are implemented.

scholarly journals Thirty-day outcomes after postnatal myelomeningocele repair: a National Surgical Quality Improvement Program Pediatric database analysis

2016 ◽  
Vol 18 (4) ◽  
pp. 416-422 ◽  
Author(s):  
Jacob Cherian ◽  
Kristen A. Staggers ◽  
I-Wen Pan ◽  
Melissa Lopresti ◽  
Andrew Jea ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Operating Room ◽  
Defect Size ◽  
Quality Improvement Program ◽  
Perioperative Outcomes ◽  
Wound Complications ◽  
Unplanned Readmission ◽  
Improvement Program ◽  
Surgical Quality ◽  
Myelomeningocele Repair

OBJECTIVE Due to improved nutrition and early detection, myelomeningocele repair is a relatively uncommon procedure. Although previous studies have reviewed surgical trends and predictors of outcomes, they have relied largely on single-hospital experiences or on databases centered on hospital admission data. Here, the authors report 30-day outcomes of pediatric patients undergoing postnatal myelomeningocele repair from a national prospective surgical outcomes database. They sought to investigate the association between preoperative and intraoperative factors on the occurrence of 30-day complications, readmissions, and unplanned return to operating room events. METHODS The 2013 American College of Surgeons National Surgical Quality Improvement Program Pediatric database (NSQIP-P) was queried for all patients undergoing postnatal myelomeningocele repair. Patients were subdivided on the basis of the size of the repair (< 5 cm vs > 5 cm). Preoperative variables, intraoperative characteristics, and postoperative 30-day events were tabulated from prospectively collected data. Three separate outcomes for complication, unplanned readmission, and return to the operating room were analyzed using univariate and multivariate logistic regression. Rates of associated CSF diversion operations and their timing were also analyzed. RESULTS A total of 114 patients were included; 54 had myelomeningocele repair for a defect size smaller than 5 cm, and 60 had repair for a defect size larger than 5 cm. CSF shunts were placed concurrently in 8% of the cases. There were 42 NSQIP-defined complications in 31 patients (27%); these included wound complications and infections, in addition to others. Postoperative wound complications were the most common and occurred in 27 patients (24%). Forty patients (35%) had at least one subsequent surgery within 30 days. Twenty-four patients (21%) returned to the operating room for initial shunt placement. Unplanned readmission occurred in 11% of cases. Both complication and return to operating room outcomes were statistically associated with age at repair. CONCLUSIONS The NSQIP-P allows examination of 30-day perioperative outcomes from a national prospectively collected database. In this cohort, over one-quarter of patients undergoing postnatal myelomeningocele repair experienced a complication within 30 days. The complication rate was significantly higher in patients who had surgical repair within the first 24 hours of birth than in patients who had surgery after the 1st day of life. The authors also highlight limitations of investigating myelomeningocele repair using NSQIP-P and advocate the importance of disease-specific data collection.

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