Associations between preoperative risks of postoperative complications: Results of an analysis of 4.8 Million ACS-NSQIP patients.

NSQIP Preoperative prediction of risk Preoperative risk prediction models SURPAS Surgical outcomes Surgical risk assessment Surgical risk calculators

Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
06 2022
Historique:
received: 24 09 2021
revised: 18 11 2021
accepted: 28 11 2021
pubmed: 9 12 2021
medline: 28 6 2022
entrez: 8 12 2021
Statut: ppublish

Résumé

Surgical Risk Preoperative Assessment System (SURPAS) estimates patient's preoperative risk of 12 postoperative complications, yet little is known about associations between these probabilities- We sought to examine relationships between predicted probabilities. Risk of 12 postoperative complications was calculated using SURPAS and the 2012-2018 ACS-NSQIP database. Pearson correlation coefficients (r) were computed to examine relationships between predicted outcomes. "High-risk" was predicted risk in the 10th decile. 4,777,267 patients were included. 71.1% were not high risk, 10.7% were high risk for 1, and 18.2% were high risk for ≥2 complications. High mortality risk was associated with high risk for pulmonary (r = 0.94), cardiac (r = 0.98), renal (r = 0.93), and stroke (0.96) complications. Patients high-risk for ≥2 complications had the most comorbidities and actual adverse outcomes. High preoperative risk for certain postoperative complications had strong correlations. 18.2% of patients were high-risk for ≥2 complications and could be targeted for risk reduction interventions.

Sections du résumé

BACKGROUND
Surgical Risk Preoperative Assessment System (SURPAS) estimates patient's preoperative risk of 12 postoperative complications, yet little is known about associations between these probabilities- We sought to examine relationships between predicted probabilities.
METHODS
Risk of 12 postoperative complications was calculated using SURPAS and the 2012-2018 ACS-NSQIP database. Pearson correlation coefficients (r) were computed to examine relationships between predicted outcomes. "High-risk" was predicted risk in the 10th decile.
RESULTS
4,777,267 patients were included. 71.1% were not high risk, 10.7% were high risk for 1, and 18.2% were high risk for ≥2 complications. High mortality risk was associated with high risk for pulmonary (r = 0.94), cardiac (r = 0.98), renal (r = 0.93), and stroke (0.96) complications. Patients high-risk for ≥2 complications had the most comorbidities and actual adverse outcomes.
CONCLUSIONS
High preoperative risk for certain postoperative complications had strong correlations. 18.2% of patients were high-risk for ≥2 complications and could be targeted for risk reduction interventions.

Identifiants

pubmed: 34876253
pii: S0002-9610(21)00709-1
doi: 10.1016/j.amjsurg.2021.11.024
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1172-1178

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Helen J Madsen (HJ)

Surgical Outcomes and Applied Research Programa, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: helen.madsen@cuanschutz.edu.

Robert A Meguid (RA)

Surgical Outcomes and Applied Research Programa, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO, USA.

Michael R Bronsert (MR)

Surgical Outcomes and Applied Research Programa, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO, USA.

Adam R Dyas (AR)

Surgical Outcomes and Applied Research Programa, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.

Kathryn L Colborn (KL)

Surgical Outcomes and Applied Research Programa, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA; Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA.

Anne Lambert-Kerzner (A)

Surgical Outcomes and Applied Research Programa, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO, USA.

William G Henderson (WG)

Surgical Outcomes and Applied Research Programa, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, CO, USA; Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA.

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