Predictive validity of the ACS-NSQIP surgical risk calculator in geriatric patients undergoing lumbar surgery
The risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) has been shown to be useful in predicting postoperative complications. In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoi...
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| Veröffentlicht in: | Medicine (Baltimore) 2017-10, Vol.96 (43), p.e8416-e8416 |
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| creator | Wang, Xiao Hu, Yanting Zhao, Binjiang Su, Yue |
| description | The risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) has been shown to be useful in predicting postoperative complications. In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoing lumbar surgery.A total of 242 geriatric patients who underwent lumbar surgery between January 2014 and December 2016 were included. Preoperative clinical information was retrospectively reviewed and entered into the ACS-NSQIP calculator. The predictive value of the ACS-NSQIP model was assessed using the Hosmer-Lemeshow test, Brier score (B), and receiver operating characteristics (ROC, also referred C-statistic) curve analysis. Additional risk factors were calculated as surgeon-adjusted risk including previous cardiac event and cerebrovascular disease.Preoperative risk factors including age (P = .004), functional independence (P = 0), American Society of Anesthesiologists class (ASA class, P = 0), dyspnea (P = 0), dialysis (P = .049), previous cardiac event (P = .001), and history of cerebrovascular disease (P = 0) were significantly associated with a greater incidence of postoperative complications. Observed and predicted incidence of postoperative complications was 43.8% and 13.7% (±5.9%) (P |
| doi_str_mv | 10.1097/MD.0000000000008416 |
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In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoing lumbar surgery.A total of 242 geriatric patients who underwent lumbar surgery between January 2014 and December 2016 were included. Preoperative clinical information was retrospectively reviewed and entered into the ACS-NSQIP calculator. The predictive value of the ACS-NSQIP model was assessed using the Hosmer-Lemeshow test, Brier score (B), and receiver operating characteristics (ROC, also referred C-statistic) curve analysis. Additional risk factors were calculated as surgeon-adjusted risk including previous cardiac event and cerebrovascular disease.Preoperative risk factors including age (P = .004), functional independence (P = 0), American Society of Anesthesiologists class (ASA class, P = 0), dyspnea (P = 0), dialysis (P = .049), previous cardiac event (P = .001), and history of cerebrovascular disease (P = 0) were significantly associated with a greater incidence of postoperative complications. Observed and predicted incidence of postoperative complications was 43.8% and 13.7% (±5.9%) (P < .01), respectively. The Hosmer-Lemeshow test demonstrated adequate predictive accuracy of the ACS-NSQIP model for all complications. However, Brier score showed that the ACS-NSQIP model could not accurately predict risk of all (B = 0.321) or serious (B = 0.241) complications, although it accurately predicted the risk of death (B = 0.0072); this was supported by ROC curve analysis. The ROC curve also showed that the model had high sensitivity and specificity for predicting renal failure and readmission.The ACS-NSQIP surgical risk calculator is not an accurate tool for the prediction of postoperative complications in geriatric Chinese patients undergoing lumbar surgery.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000008416</identifier><identifier>PMID: 29069040</identifier><language>eng</language><publisher>United States: The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Aged ; Aged, 80 and over ; Female ; Geriatric Assessment - methods ; Geriatric Assessment - statistics & numerical data ; Humans ; Incidence ; Laminectomy - adverse effects ; Laminectomy - methods ; Lumbar Vertebrae - surgery ; Male ; Middle Aged ; Observational Study ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment - methods ; Risk Assessment - statistics & numerical data ; Risk Factors ; ROC Curve ; Sensitivity and Specificity ; Spinal Stenosis - surgery</subject><ispartof>Medicine (Baltimore), 2017-10, Vol.96 (43), p.e8416-e8416</ispartof><rights>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5167-23f049415f5281442f52513327a02e1fe3265f76ca96d8e100c95f56002352c3</citedby><cites>FETCH-LOGICAL-c5167-23f049415f5281442f52513327a02e1fe3265f76ca96d8e100c95f56002352c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671873/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671873/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29069040$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Xiao</creatorcontrib><creatorcontrib>Hu, Yanting</creatorcontrib><creatorcontrib>Zhao, Binjiang</creatorcontrib><creatorcontrib>Su, Yue</creatorcontrib><title>Predictive validity of the ACS-NSQIP surgical risk calculator in geriatric patients undergoing lumbar surgery</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>The risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) has been shown to be useful in predicting postoperative complications. In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoing lumbar surgery.A total of 242 geriatric patients who underwent lumbar surgery between January 2014 and December 2016 were included. Preoperative clinical information was retrospectively reviewed and entered into the ACS-NSQIP calculator. The predictive value of the ACS-NSQIP model was assessed using the Hosmer-Lemeshow test, Brier score (B), and receiver operating characteristics (ROC, also referred C-statistic) curve analysis. Additional risk factors were calculated as surgeon-adjusted risk including previous cardiac event and cerebrovascular disease.Preoperative risk factors including age (P = .004), functional independence (P = 0), American Society of Anesthesiologists class (ASA class, P = 0), dyspnea (P = 0), dialysis (P = .049), previous cardiac event (P = .001), and history of cerebrovascular disease (P = 0) were significantly associated with a greater incidence of postoperative complications. Observed and predicted incidence of postoperative complications was 43.8% and 13.7% (±5.9%) (P < .01), respectively. The Hosmer-Lemeshow test demonstrated adequate predictive accuracy of the ACS-NSQIP model for all complications. However, Brier score showed that the ACS-NSQIP model could not accurately predict risk of all (B = 0.321) or serious (B = 0.241) complications, although it accurately predicted the risk of death (B = 0.0072); this was supported by ROC curve analysis. The ROC curve also showed that the model had high sensitivity and specificity for predicting renal failure and readmission.The ACS-NSQIP surgical risk calculator is not an accurate tool for the prediction of postoperative complications in geriatric Chinese patients undergoing lumbar surgery.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Female</subject><subject>Geriatric Assessment - methods</subject><subject>Geriatric Assessment - statistics & numerical data</subject><subject>Humans</subject><subject>Incidence</subject><subject>Laminectomy - adverse effects</subject><subject>Laminectomy - methods</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observational Study</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Assessment - statistics & numerical data</subject><subject>Risk Factors</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Spinal Stenosis - surgery</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU1vFDEMhiMEotvCL0BCOXKZku9sLkjVlo9KLRS19yjNeGZDMzNLktlq_z1pt1QFX2w5rx87ehF6R8kxJUZ_vDg9Js9iKah6gRZUctVIo8RLtCCEyUYbLQ7QYc6_CKFcM_EaHTBDlCGCLNBwmaANvoQt4K2LoQ1lh6cOlzXgk9VV8_3q59klznPqg3cRp5BvcS38HF2ZEg4j7iEFV1LweONKgLFkPI8tpH4KY4_jPNy49ACAtHuDXnUuZnj7mI_Q9ZfP16tvzfmPr2erk_PGS6p0w3hHhBFUdpItqRCsZkk5Z9oRBrQDzpTstPLOqHYJlBBvqlbV_3LJPD9Cn_bYzXwzQOvrUclFu0lhcGlnJxfsvy9jWNt-2lqpNF1qXgEfHgFp-j1DLnYI2UOMboRpzpaausxQpnWV8r3UpynnBN3TGkrsvU_24tT-71Odev_8wqeZv8ZUgdgL7qZYIOXbON9BsmtwsawfeFIb1jBCNSVMk6Z2lOZ_AL3BnfY</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Wang, Xiao</creator><creator>Hu, Yanting</creator><creator>Zhao, Binjiang</creator><creator>Su, Yue</creator><general>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</general><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20171001</creationdate><title>Predictive validity of the ACS-NSQIP surgical risk calculator in geriatric patients undergoing lumbar surgery</title><author>Wang, Xiao ; Hu, Yanting ; Zhao, Binjiang ; Su, Yue</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5167-23f049415f5281442f52513327a02e1fe3265f76ca96d8e100c95f56002352c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Female</topic><topic>Geriatric Assessment - methods</topic><topic>Geriatric Assessment - statistics & numerical data</topic><topic>Humans</topic><topic>Incidence</topic><topic>Laminectomy - adverse effects</topic><topic>Laminectomy - methods</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observational Study</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Assessment - statistics & numerical data</topic><topic>Risk Factors</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Spinal Stenosis - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Xiao</creatorcontrib><creatorcontrib>Hu, Yanting</creatorcontrib><creatorcontrib>Zhao, Binjiang</creatorcontrib><creatorcontrib>Su, Yue</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Xiao</au><au>Hu, Yanting</au><au>Zhao, Binjiang</au><au>Su, Yue</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive validity of the ACS-NSQIP surgical risk calculator in geriatric patients undergoing lumbar surgery</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>96</volume><issue>43</issue><spage>e8416</spage><epage>e8416</epage><pages>e8416-e8416</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>The risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) has been shown to be useful in predicting postoperative complications. In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoing lumbar surgery.A total of 242 geriatric patients who underwent lumbar surgery between January 2014 and December 2016 were included. Preoperative clinical information was retrospectively reviewed and entered into the ACS-NSQIP calculator. The predictive value of the ACS-NSQIP model was assessed using the Hosmer-Lemeshow test, Brier score (B), and receiver operating characteristics (ROC, also referred C-statistic) curve analysis. Additional risk factors were calculated as surgeon-adjusted risk including previous cardiac event and cerebrovascular disease.Preoperative risk factors including age (P = .004), functional independence (P = 0), American Society of Anesthesiologists class (ASA class, P = 0), dyspnea (P = 0), dialysis (P = .049), previous cardiac event (P = .001), and history of cerebrovascular disease (P = 0) were significantly associated with a greater incidence of postoperative complications. Observed and predicted incidence of postoperative complications was 43.8% and 13.7% (±5.9%) (P < .01), respectively. The Hosmer-Lemeshow test demonstrated adequate predictive accuracy of the ACS-NSQIP model for all complications. However, Brier score showed that the ACS-NSQIP model could not accurately predict risk of all (B = 0.321) or serious (B = 0.241) complications, although it accurately predicted the risk of death (B = 0.0072); this was supported by ROC curve analysis. The ROC curve also showed that the model had high sensitivity and specificity for predicting renal failure and readmission.The ACS-NSQIP surgical risk calculator is not an accurate tool for the prediction of postoperative complications in geriatric Chinese patients undergoing lumbar surgery.</abstract><cop>United States</cop><pub>The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>29069040</pmid><doi>10.1097/MD.0000000000008416</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Female Geriatric Assessment - methods Geriatric Assessment - statistics & numerical data Humans Incidence Laminectomy - adverse effects Laminectomy - methods Lumbar Vertebrae - surgery Male Middle Aged Observational Study Postoperative Complications - epidemiology Postoperative Complications - etiology Predictive Value of Tests Retrospective Studies Risk Assessment - methods Risk Assessment - statistics & numerical data Risk Factors ROC Curve Sensitivity and Specificity Spinal Stenosis - surgery |
| title | Predictive validity of the ACS-NSQIP surgical risk calculator in geriatric patients undergoing lumbar surgery |
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