Patient-specific risk factors are predictive for postoperative adverse events in colorectal surgery: an American College of Surgeons National Surgical Quality Improvement Program–based analysis

2015 ◽  
Vol 209 (2) ◽  
pp. 219-229 ◽  
Author(s):  
Adrian Y. Kohut ◽  
James J. Liu ◽  
David E. Stein ◽  
Richard Sensenig ◽  
Juan L. Poggio
Keyword(s):  
Risk Factors ◽  
Quality Improvement ◽  
Colorectal Surgery ◽  
Adverse Events ◽  
Quality Improvement Program ◽  
Patient Specific ◽  
Improvement Program ◽  
Surgical Quality ◽  
Specific Risk ◽  
American College Of Surgeons

Risk Factors for Conversion from Laparoscopic to Open Surgery: Analysis of 2138 Converted Operations in the American College of Surgeons National Surgical Quality Improvement Program

2013 ◽  
Vol 79 (9) ◽  
pp. 914-921 ◽  
Author(s):  
Dominic Papandria ◽  
Thomas Lardaro ◽  
Daniel Rhee ◽  
Gezzer Ortega ◽  
Amany Gorgy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Quality Improvement ◽  
Open Surgery ◽  
Quality Improvement Program ◽  
Laparoscopic Procedure ◽  
Improvement Program ◽  
Cross Sectional ◽  
Surgical Quality ◽  
Acs Nsqip ◽  
American College Of Surgeons

Minimal access procedures have influenced surgical practice and patient expectations. Risk of laparoscopic conversion to open surgery is frequently cited but vaguely quantified. The present study examines three common procedures to identify risk factors for laparoscopic conversion to open (LCO) events. Cross-sectional analysis using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP; 2005 to 2009) identified cases with laparoscopic procedure codes for appendectomy, cholecystectomy, and bariatric procedures. The primary outcome was conversion of a laparoscopic procedure to its open equivalent. Summary statistics for laparoscopic and LCO groups were compared and logistic regression analysis was used to estimate patient and operative risk factors for conversion. Of 176,014 selected laparoscopic operations, 2,138 (1.2%) were converted. Most patients were female (68%) and white (71.2%); mean age was 45.1 years. LCO cholecystectomy was significantly more likely (n = 1526 [1.9%]) and LCO bariatric procedures were less likely (n = 121 [0.3%]); appendectomy was intermediate (n = 491 [1.0%], P < 0.001). Patient factors associated with LCO included male sex ( P < 0.001), age 30 years or older ( P < 0.025), American Society of Anesthesiologists Class 2 to 4 ( P < 0.001), obesity ( P < 0.01), history of bleeding disorder ( P = 0.036), or preoperative systemic inflammatory response syndrome or sepsis ( P < 0.001). LCO was associated with greater incidence of postoperative complications, including death, organ space surgical site infection, sepsis, wound dehiscence, and return to the operating room ( P < 0.001). Overall LCO incidence is low in hospitals participating in ACS-NSQIP. Conversion risk factors include patient age, sex, obesity, and preoperative comorbidity as well as the procedure performed. This information should be valuable to clinicians in discussing conversion risk with patients.

Predictors of Adverse Events after Neck Dissection: An Analysis of the 2006–2011 National Surgical Quality Improvement Program (NSQIP) Database

2017 ◽  
Vol 96 (2) ◽  
pp. E37-E45 ◽  
Author(s):  
Umang Jain ◽  
Jessica Somerville ◽  
Sujata Saha ◽  
Jon P. Ver Halen ◽  
Anuja K. Antony ◽  
...  
Keyword(s):  
Risk Factors ◽  
Quality Improvement ◽  
Adverse Events ◽  
Neck Dissection ◽  
Multivariate Regression Analysis ◽  
Quality Improvement Program ◽  
Patient Counseling ◽  
Improvement Program ◽  
Surgical Quality ◽  
Factors Associated

While neck dissection is an important primary and adjunctive procedure in the treatment of head and neck cancer, there is a paucity of studies evaluating outcomes. A retrospective review of the National Surgical Quality Improvement Program (NSQIP) database was performed to identify factors associated with adverse events (AEs) in patients undergoing neck dissection. A total of 619 patients were identified, using CPT codes specific to neck dissection. Of the 619 patients undergoing neck dissection, 142 (22.9%) experienced an AE within 30 days of the surgical procedure. Risk factors on multivariate regression analysis associated with increased AEs included dyspnea (odds ratio [OR] 2.57; 95% confidence interval [CI] 1.06 to 6.22; p = 0.037), previous cardiac surgery (OR 3.38; 95% CI 1.08 to 10.52; p = 0.036), increasing anesthesia time (OR 1.005; 95% CI 1 to 1.009; p = 0.036), and increasing total work relative value units (OR 1.09; CI 1.04 to 1.13; p < 0.001). The current study is the largest, most robust analysis to identify specific risk factors associated with AEs after neck dissection. This information will assist with preoperative optimization, patient counseling, and appropriate risk stratification, and it can serve as benchmarking for institutions comparing surgical outcomes.

scholarly journals Risk Factors for Venous Thromboembolism following Thoracolumbar Surgery: Analysis of 43,777 Patients from the American College of Surgeons National Surgical Quality Improvement Program 2005 to 2012

2016 ◽  
Vol 6 (8) ◽  
pp. 738-743 ◽  
Author(s):  
Arjun S. Sebastian ◽  
Bradford L. Currier ◽  
Sanjeev Kakar ◽  
Emily C. Nguyen ◽  
Amy E. Wagie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Quality Improvement ◽  
Venous Thromboembolism ◽  
Spine Surgery ◽  
Thoracolumbar Spine ◽  
Quality Improvement Program ◽  
National Database ◽  
Improvement Program ◽  
Surgical Quality ◽  
American College Of Surgeons

Study Design Retrospective clinical study of a prospectively collected, national database. Objective Determine the 30-day incidence, timing, and risk factors for venous thromboembolism (VTE) following thoracolumbar spine surgery. Methods The American College of Surgeons National Surgical Quality Improvement Program Participant Use File identified 43,777 patients who underwent thoracolumbar surgery from 2005 to 2012. Multiple patient characteristics were identified. The incidence and timing (in days) of deep vein thrombosis (DVT) and pulmonary embolus (PE) were determined. Multivariable regression analysis was performed to identify significant risk factors. Results Of the 43,777 patients identified as having had thoracolumbar surgery, 202 cases of PE (0.5%) and 311 cases of DVT (0.7%) were identified. VTE rates were highest in patients undergoing corpectomy, with a 1.7% PE rate and a 3.8% DVT rate. Independent risk factors for VTE included length of stay (LOS) ≥ 6 days (odds ratio [OR] 4.07), disseminated cancer (OR 1.77), white blood cell count > 12 (OR 1.76), paraplegia (OR 1.75), albumin < 3 (OR 1.73), American Society of Anesthesiologists class 4 or greater (OR 1.54), body mass index > 40 (OR 1.49), and operative time > 193 minutes (OR 1.43). LOS < 3 days was protective (OR 0.427). Conclusions We report an overall 30-day PE rate of 0.5% and DVT rate of 0.7% following thoracolumbar spine surgery. Patients undergoing corpectomy were at highest risk for VTE. Multiple VTE risk factors were identified. Further studies are needed to develop algorithms to stratify VTE risk and direct prophylaxis accordingly.

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