Do complications muddle NSQIP risk calculator validity?



The American College of Surgeons’ NSQIP surgical risk calculator was effective for evaluating patients at average surgical risk undergoing laparoscopic colectomy at a single institution, but did not accurately predict outcomes in a small percentage of patients when one or more serious complications occurred, a new study has found.

Specifically, the actual length of stay (LOS) was significantly longer than predicted by the calculator (4.22 days vs. 4.11 days; P = .0001), with four outliers with multiple complications having an LOS more than 3 standard deviations from the mean. After removing the outliers, the actual LOS was significantly shorter than that predicted (3.31 days vs. 4.05 days; P = .002). Occurrence of any complication was also significantly lower than predicted (17.3% vs. 19.4%; P = .05).

“Addition of surgeon- and patient-specific data via the American College of Surgeons case-logging system could better adjust for these areas,” study author Dr. Kyle Cologne and his colleagues recommend.

Read the full article at J. Am. Coll. Surg. 2015;220:281-6.

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