scholarly journals Predicting Risk of Death in General Surgery Patients on the Basis of Preoperative Variables Using American College of Surgeons National Surgical Quality Improvement Program Data

2012 ◽  
pp. 10-17 ◽  
Author(s):  
Sachin Vaid
Keyword(s):  
Quality Improvement ◽  
General Surgery ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Surgical Quality ◽  
Risk Of Death ◽  
American College Of Surgeons ◽  
Program Data

A Critical Assessment of Outcomes in Emergency versus Nonemergency General Surgery Using the American College of Surgeons National Surgical Quality Improvement Program Database

2011 ◽  
Vol 77 (7) ◽  
pp. 951-959 ◽  
Author(s):  
Robert D. Becher ◽  
J. Jason Hoth ◽  
Preston R. Miller ◽  
Nathan T. Mowery ◽  
Michael C. Chang ◽  
...  
Keyword(s):  
Quality Improvement ◽  
General Surgery ◽  
Postoperative Morbidity ◽  
Inflammatory Responses ◽  
Systems Of Care ◽  
Quality Improvement Program ◽  
Morbidity And Mortality ◽  
Improvement Program ◽  
Surgical Quality ◽  
American College Of Surgeons

Emergent operations are thought to carry higher morbidity and mortality than nonemergent cases. However, there is a lack of specific outcomes data for emergent general surgery procedures. The objective of our study was to assess and quantify postoperative morbidity and mortality for emergency versus nonemergency general surgery operations. All general surgery inpatients were identified in the American College of Surgeons National Surgical Quality Improvement Program 2008 database. Preoperative, intraoperative, and postoperative clinical metrics and occurrences were assessed. A total of 25,770 emergent and 98,867 nonemergent cases were identified. Postoperative morbidity was significantly worse in the emergent group, including ventilation more than 48 hours, bleeding requiring transfusion, deep vein thrombosis, renal failure, and need for reoperation. Overall, emergent cases had significantly more postoperative complications (22.8% vs 14.2%) and higher mortality rates (6.5% vs 1.4%). General surgery patients who undergo emergent operations have significantly poorer outcomes when compared with nonemergent patients; our analysis has quantified these differences. Emergent patients seem to manifest unique clinical, pathophysiologic, and inflammatory responses to their surgical disease. This data suggests that there is a need for improvement in both methods and systems of care for the emergent population.

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