scholarly journals Analysis of the American College of Surgeons National Surgical Quality Improvement Program® (ACS NSQIP®) database to identify factors associated with postoperative mortality after elective non-cardiac surgery

2020 ◽  
Author(s):  
Amit K. Malviya ◽  
Melanio Bruceta ◽  
Preet M. Singh ◽  
Anthony Bonavia ◽  
Kunal Karamchandani
Keyword(s):  
Cardiac Surgery ◽  
Odds Ratio ◽  
Postoperative Mortality ◽  
Functional Health ◽  
Functional Health Status ◽  
Physical Status ◽  
Improvement Program ◽  
Surgical Quality ◽  
Acs Nsqip ◽  
American College Of Surgeons

Abstract Background Various surgical risk assessment tools, including the American College of Surgeons National Surgical Quality Improvement Program® (ACS NSQIP®) risk calculator have been devised to predict post-operative mortality. However, the role of individual factors on mortality is unclear. We sought to identify patient characteristics from the database that were associated with postoperative mortality in patients undergoing elective, non-cardiac surgery.Methods Data from the ACS NSQIP® database at a tertiary care academic medical center was analyzed from January 2011 to September 2016. Relevant patient related variables were extracted from the database and univariable logistic regression was used to assess the association of each potential risk factor with 30-day mortality. A multivariable logistic regression model was then used to assess the adjusted effect of each potential risk factor on the outcome.Results 5,254 database patient records were identified and among the analyzed variables, American Society of Anesthesiologists (ASA) physical status III and IV (odds ratio and 95%CI : 16.75 [2.29, 122.69] ), poor preoperative functional health status (Odds ratio and 95%CI : 38.52 [2.46, 604.12] ), and low serum albumin (Odds ratio and 95%CI : 3.76 [1.35, 10.44]) were significant predictors of 30-day postoperative mortality.Conclusions In a comprehensive analysis of the ACS NSQIP®database, spreading across multiple surgical specialties, we found an association between ASA physical status, preoperative albumin levels, and functional health status with 30-day mortality after elective non-cardiac surgery.

scholarly journals Analysis of the American College of Surgeons National Surgical Quality Improvement ProgramÒ (ACS NSQIPÒ) database to identify factors associated with postoperative mortality after elective non-cardiac surgery

2021 ◽  
Author(s):  
Amit K. Malviya ◽  
Melanio Bruceta ◽  
Preet M. Singh ◽  
Anthony Bonavia ◽  
Kunal Karamchandani ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Risk Factor ◽  
Odds Ratio ◽  
Postoperative Mortality ◽  
Functional Health ◽  
Functional Health Status ◽  
Physical Status ◽  
Surgical Quality ◽  
Acs Nsqip ◽  
American College Of Surgeons

Abstract Background: Various surgical risk assessment tools, including the American College of Surgeons National Surgical Quality Improvement ProgramÒ (ACS NSQIPÒ) risk calculator have been devised to predict post-operative mortality. However, the role of individual factors on mortality is unclear. We sought to identify patient characteristics from the database that were associated with postoperative mortality in patients undergoing elective, non-cardiac surgery. Methods: Data from the ACS NSQIPÒ database at a tertiary care academic medical center was analyzed from January 2011 to September 2016. Relevant patient related variables were extracted from the database and univariable logistic regression was used to assess the association of each potential risk factor with 30-day mortality. A multivariable logistic regression model was then used to assess the adjusted effect of each potential risk factor on the outcome. Results: 5,254 database patient records were identified and among the analyzed variables, American Society of Anesthesiologists (ASA) physical status III and IV (odds ratio and 95%CI : 16.75 [2.29, 122.69] ), poor preoperative functional health status (Odds ratio and 95%CI : 38.52 [2.46, 604.12] ), and low serum albumin (Odds ratio and 95%CI : 3.76 [1.35, 10.44]) were significant predictors of 30-day postoperative mortality.Conclusions: In a comprehensive analysis of the ACS NSQIPÒdatabase, spreading across multiple surgical specialties, we found an association between ASA physical status, preoperative albumin levels, and functional health status with 30-day mortality after elective non-cardiac surgery.

The effect of vascular reconstruction on early postoperative outcomes after pancreaticoduodenectomy: An analysis of the American College of Surgeons National Surgical Quality Improvement Program database.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 153-153
Author(s):  
Anthony W. Castleberry ◽  
Rebekah Ruth White ◽  
Sebastian G. De La Fuente ◽  
Douglas S. Tyler ◽  
Theodore N. Pappas ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Postoperative Mortality ◽  
Vascular Reconstruction ◽  
Quality Improvement Program ◽  
Surgical Team ◽  
Single Center ◽  
Improvement Program ◽  
Surgical Quality ◽  
Acs Nsqip ◽  
American College Of Surgeons

153 Background: Several single-center reports have been published suggesting that vascular reconstruction (VR) during pancreaticoduodenectomy (PD) allows an acceptable oncologic outcome in patients with pancreatic adenocarcinoma without affecting early postoperative mortality or morbidity. The objective of our study was to review the outcomes associated with VR during PD using a large multicenter data source. Methods: A retrospective cohort analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Participant User Files for 2005-2009. All patients undergoing PD for a postoperative diagnosis of malignant neoplasm of the pancreas were included. Forward stepwise multivariate regression analysis was used to determine the association between VR during PD and 30-day postoperative mortality and morbidity after adjusting for patient demographics and comorbidities. Results: 3582 patients were included for analysis, 281 (7.8%) of whom underwent VR during PD. VR during PD was associated with significantly greater risk-adjusted 30-day postoperative mortality (5.7% with VR vs. 2.9% without VR, Adjusted Odds Ratio (AOR) 2.1, 95% CI 1.22-3.73, p = 0.008) and overall morbidity (39.9% with VR vs. 33.3% without VR, AOR 1.36, 95% CI 1.05-1.75, p = 0.02). Patients undergoing VR required significantly longer operative times, and were more likely to require intraoperative transfusion or early reoperation, than patients not undergoing VR during PD. There was no significant difference in risk-adjusted postoperative mortality or morbidity between those patients undergoing VR by the primary surgical team versus those patients undergoing VR by a vascular surgical team. Conclusions: Contrary to the findings of several previously published single-center analyses, data from ACS-NSQIP suggests that VR significantly increases the risk of 30-day postoperative death or complications after PD. Patients who may require VR during PD will likely benefit from referral to centers with sufficient experience with this procedure.

Outcomes of Ileal Pouch Excision: an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Analysis

2018 ◽  
Vol 22 (12) ◽  
pp. 2142-2149
Author(s):  
Sebastien Lachance ◽  
Maria Abou-Khalil ◽  
Carol-Ann Vasilevsky ◽  
Gabriela Ghitulescu ◽  
Nancy Morin ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Ileal Pouch ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Surgical Quality ◽  
Acs Nsqip ◽  
American College Of Surgeons ◽  
Pouch Excision

Same-day and delayed hospital discharge are associated with worse outcomes following total knee arthroplasty

2019 ◽  
Vol 101-B (7_Supple_C) ◽  
pp. 70-76 ◽  
Author(s):  
L. L. Nowak ◽  
E. H. Schemitsch
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Odds Ratio ◽  
Matched Cohort ◽  
Improvement Program ◽  
Surgical Quality ◽  
Increased Risk ◽  
American College Of Surgeons ◽  
Multivariable Regression ◽  
Total Knee

Aims To evaluate the influence of discharge timing on 30-day complications following total knee arthroplasty (TKA). Patients and Methods We identified patients aged 18 years or older who underwent TKA between 2005 and 2016 from the American College of Surgeons’ National Surgical Quality Improvement Program (NSQIP) database. We propensity score-matched length-of-stay (LOS) groups using all relevant covariables. We used multivariable regression to determine if the rate of complications and re-admissions differed depending on LOS. Results Our matched cohort consisted of 76 246 TKA patients (mean age 67 years (sd 9)). Patients whose LOS was zero and four days had an increased risk of major complications by an odds ratio (OR) of 1.8 (95% confidence interval (CI) 1.0 to 3.2) and 1.5 (95% CI 1.2 to 1.7), respectively, compared with patients whose LOS was two days. Patients whose LOS was zero, three, and four days had an increased risk of minor complications (OR 1.8 (95% CI 1.3 to 2.7), 1.2 (95% CI 1.0 to 1.4), and 1.6 (95% CI 1.4 to 1.9), respectively), compared with patients whose LOS was two days. In addition, a LOS of three days increased the risk of re-admission by an OR of 1.2 (95% CI 1.0 to 1.3), and a LOS of four days increased the risk of re-admission by an OR of 1.5 (95% CI 1.3 to 1.6), compared with a LOS of two days. Conclusion Patients discharged on days one to two postoperatively following TKA appear to have reduced major and minor complications compared with discharge on the day of surgery, or on days three to four. Prospective clinical data are required to confirm these findings. Cite this article: Bone Joint J 2019;101-B(7 Supple C):70–76

Sign in / Sign up

Export Citation Format

Share Document