Development and validation of a multivariable preoperative prediction model for postoperative length of stay in a broad inpatient surgical population.
Journal
Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347
Informations de publication
Date de publication:
07 2023
07 2023
Historique:
received:
20
10
2022
revised:
16
01
2023
accepted:
23
02
2023
pmc-release:
01
07
2024
medline:
16
6
2023
pubmed:
7
5
2023
entrez:
6
5
2023
Statut:
ppublish
Résumé
Postoperative length of stay is a meaningful patient-centered outcome and an important determinant of healthcare costs. The Surgical Risk Preoperative Assessment System preoperatively predicts 12 postoperative adverse events using 8 preoperative variables, but its ability to predict postoperative length of stay has not been assessed. We aimed to determine whether the Surgical Risk Preoperative Assessment System variables could accurately predict postoperative length of stay up to 30 days in a broad inpatient surgical population. This was a retrospective analysis of the American College of Surgeons' National Surgical Quality Improvement Program adult database from 2012 to 2018. A model using the Surgical Risk Preoperative Assessment System variables and a 28-variable "full" model, incorporating all available American College of Surgeons' National Surgical Quality Improvement Program preoperative nonlaboratory variables, were fit to the analytical cohort (2012-2018) using multiple linear regression and compared using model performance metrics. Internal chronological validation of the Surgical Risk Preoperative Assessment System model was conducted using training (2012-2017) and test (2018) datasets. We analyzed 3,295,028 procedures. The adjusted R The parsimonious Surgical Risk Preoperative Assessment System model can preoperatively predict postoperative length of stay up to 30 days for inpatient surgical procedures almost as accurately as a model using all 28 American College of Surgeons' National Surgical Quality Improvement Program preoperative nonlaboratory variables and has shown acceptable internal chronological validation.
Sections du résumé
BACKGROUND
Postoperative length of stay is a meaningful patient-centered outcome and an important determinant of healthcare costs. The Surgical Risk Preoperative Assessment System preoperatively predicts 12 postoperative adverse events using 8 preoperative variables, but its ability to predict postoperative length of stay has not been assessed. We aimed to determine whether the Surgical Risk Preoperative Assessment System variables could accurately predict postoperative length of stay up to 30 days in a broad inpatient surgical population.
METHODS
This was a retrospective analysis of the American College of Surgeons' National Surgical Quality Improvement Program adult database from 2012 to 2018. A model using the Surgical Risk Preoperative Assessment System variables and a 28-variable "full" model, incorporating all available American College of Surgeons' National Surgical Quality Improvement Program preoperative nonlaboratory variables, were fit to the analytical cohort (2012-2018) using multiple linear regression and compared using model performance metrics. Internal chronological validation of the Surgical Risk Preoperative Assessment System model was conducted using training (2012-2017) and test (2018) datasets.
RESULTS
We analyzed 3,295,028 procedures. The adjusted R
CONCLUSION
The parsimonious Surgical Risk Preoperative Assessment System model can preoperatively predict postoperative length of stay up to 30 days for inpatient surgical procedures almost as accurately as a model using all 28 American College of Surgeons' National Surgical Quality Improvement Program preoperative nonlaboratory variables and has shown acceptable internal chronological validation.
Identifiants
pubmed: 37149424
pii: S0039-6060(23)00113-7
doi: 10.1016/j.surg.2023.02.024
pmc: PMC10272088
mid: NIHMS1880910
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
66-74Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR002535
Pays : United States
Informations de copyright
Copyright © 2023 Elsevier Inc. All rights reserved.
Références
Am J Surg. 2020 Jun;219(6):1065-1072
pubmed: 31376949
Clin Spine Surg. 2016 Feb;29(1):E34-42
pubmed: 24525748
J Am Coll Surg. 2020 Jan;230(1):64-75.e2
pubmed: 31672678
J Am Coll Surg. 2016 Aug;223(2):286-90
pubmed: 27118713
J Minim Invasive Gynecol. 2019 Nov - Dec;26(7):1303-1310
pubmed: 30611974
Eur J Cardiothorac Surg. 2016 Apr;49(4):e65-71
pubmed: 26823164
Spine (Phila Pa 1976). 2021 Apr 15;46(8):487-491
pubmed: 33306614
Patient Saf Surg. 2020 Jul 25;14:31
pubmed: 32724336
Ann Surg. 2009 Dec;250(6):901-7
pubmed: 19953710
PLoS One. 2018 Apr 13;13(4):e0195901
pubmed: 29652932
Surgery. 2020 Dec;168(6):1152-1159
pubmed: 32900494
J Surg Educ. 2020 Jul - Aug;77(4):911-920
pubmed: 32192884
Interact Cardiovasc Thorac Surg. 2016 Aug;23(2):208-15
pubmed: 27073262
Ann Surg. 2016 Jul;264(1):10-22
pubmed: 26945154
JAMA Netw Open. 2021 Sep 1;4(9):e2125846
pubmed: 34542615
Am J Surg. 2021 Sep;222(3):643-649
pubmed: 33485618
Ann Surg. 2016 Jun;263(6):1039-41
pubmed: 27167560
Ann Surg. 2016 Jul;264(1):23-31
pubmed: 26928465
J Exerc Rehabil. 2015 Apr 30;11(2):67-73
pubmed: 25960978
J Arthroplasty. 2021 Sep;36(9):3073-3077
pubmed: 33933330
Ann Thorac Surg. 2002 Aug;74(2):464-73
pubmed: 12173830
Ann Surg. 2016 Jun;263(6):1042-8
pubmed: 26954897
Patient Saf Surg. 2018 Jun 04;12:12
pubmed: 29881458
J Am Coll Surg. 2013 Nov;217(5):833-42.e1-3
pubmed: 24055383
J Am Coll Surg. 2020 Jun;230(6):1025-1033.e1
pubmed: 32251847
Surgery. 2021 Oct;170(4):1184-1194
pubmed: 33867167
J Am Coll Surg. 2017 May;224(5):787-795.e1
pubmed: 28389191
J Invest Surg. 2021 Dec;34(12):1399-1406
pubmed: 32791866
J Am Coll Surg. 2016 Oct;223(4):674-5
pubmed: 27687839
PLoS One. 2014 Oct 31;9(10):e109684
pubmed: 25360612
PLOS Digit Health. 2022 Apr 14;1(4):e0000017
pubmed: 36812502
Neurosurg Focus. 2015 Dec;39(6):E12
pubmed: 26621410
World J Surg. 2020 Nov;44(11):3751-3760
pubmed: 32737558
Int Orthop. 2017 May;41(5):859-868
pubmed: 28224191
J Am Acad Orthop Surg Glob Res Rev. 2021 May 4;5(5):e21.00073
pubmed: 33945514
J Am Coll Surg. 2016 Aug;223(2):231-9
pubmed: 27212006
BMC Health Serv Res. 2021 Sep 9;21(1):940
pubmed: 34503494
J Trauma Acute Care Surg. 2019 Aug;87(2):408-412
pubmed: 30958809
Surgery. 2019 Nov;166(5):812-819
pubmed: 31272812
Patient Saf Surg. 2019 Aug 20;13:28
pubmed: 31452684
Singapore Med J. 2021 Oct 24;:
pubmed: 34688227