Associations between preoperative risks of postoperative complications: Results of an analysis of 4.8 Million ACS-NSQIP patients - 20/06/22
, Robert A. Meguid a, b, Michael R. Bronsert a, b, Adam R. Dyas a, Kathryn L. Colborn a, c, Anne Lambert-Kerzner a, b, William G. Henderson a, b, cAbstract |
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.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Preoperative assessment of predicted surgical risk identifies vulnerable patients. |
• | Our surgical risk calculator predicts high-risk for postoperative complications. |
• | Preoperatively predicted surgical risks are associated with each other. |
• | Patients at preoperatively predicted risk of ≥2 adverse outcomes are vulnerable. |
• | Patients predicted as high-risk of ≥2 adverse outcomes have most adverse outcomes. |
Mots-clés : SURPAS
Keywords : Preoperative risk prediction models, Preoperative prediction of risk, SURPAS, NSQIP, Surgical outcomes, Surgical risk assessment, Surgical risk calculators
Plan
Vol 223 - N° 6
P. 1172-1178 - juin 2022 Retour au numéro
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