Complications in NSQIP Patients
Similar to Those in Healy, et al.

This web resource allows the user to select any of seven case scenarios featuring extremely medically complex patients requiring surgical intervention. The user may then select risk-factors from the scenario to subset NSQIP data between 2012-16 and learn how many patients in NSQIP match the selected criteria and what number and percentage experienced morbidity or mortality. This information is intended to demonstrate how prevalent or uncommon different combinations of procedures and risk-factors are in the NSQIP database, and how knowing the number of patients matching a particular set of risk-factors and their actual outcomes in NSQIP can supplement American College of Surgeons Surgical Risk Calculator (ACS-Calculator) risk estimates.

General Notes: Case scenarios and risk-factors are those presented in Healy, et al., "Comparison of Internal Medicine and General Surgery Residents' Assessments of Risk of Postsurgical Complications in Surgically Complex Patients," (JAMA Surg. 2017 Oct 11. doi: 10.1001/jamasurg.2017.3936). This webpage presents original analysis of the American College of Surgeons National Surgical Quality Improvement Database (ACS-NSQIP). Included data are all surgical procedures collected in 2012-2016 (n=3,832,653 patients).

All risk-factors are treated as binary and are either included for subsetting or ignored. For example, in a scenario that specifies a female patient, if the "Sex: Female" box is unselected, results in male and female patients are presented. If the box is selected, the results shown are those limited to female patients. For age and BMI, subsetting uses the same age and BMI ranges included in the ACS-Calculator. Risk-factors are as recorded in NSQIP Participant-User-Data-Files. Morbidity was defined as in the ACS-Calculator as any NSQIP-recorded complication, reoperation, or death within 30-days. In the accompanying publication, ACS-Calculator estimates were obtained by entering the risk-factors for each scenario into the calculator and recording the risk estimated for "Any Complication". Risk predictions by the older version of the ACS-Calculator are those reported by Healy et al. When values such as BMI were not specified in the scenario, normal-range values were used.

Webpage Copyright 2017-18: Sherman, S.K.; Poli, E.C.; Kapadia, M.R.; Turaga, K.K.
(Link to Publication)