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    Does the ACS NSQIP Surgical Risk Calculator Accurately Predict Complications Rates After Anterior Lumbar Interbody Fusion Procedures

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    Authors
    Narain, Ankur S.
    Kitto, Alexander Z.
    Braun, Benjamin M.
    Poorman, Matthew J.
    Curtin, Patrick
    Slavin, Justin
    Whalen, Giles F.
    DiPaola, Christian P.
    Connolly, Patrick J.
    Stauff, Michael P.
    UMass Chan Affiliations
    Department of Orthopedics and Physical Rehabilitation
    Department of Neurological Surgery
    Department of Surgery
    Document Type
    Journal Article
    Publication Date
    2020-12-17
    Keywords
    ALIF
    ACS NSQIP Surgical Risk Calculator
    Complications
    Risk Stratification
    Predictive Tools
    Neurosurgery
    Orthopedics
    Surgery
    Surgical Procedures, Operative
    
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    Link to Full Text
    https://doi.org/10.1097/brs.0000000000003893
    Abstract
    STUDY DESIGN: Clinical case series. OBJECTIVE: To determine the effectiveness of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) surgical risk calculator in the prediction of complications after anterior lumbar interbody fusion (ALIF). SUMMARY OF BACKGROUND DATA: Identifying at-risk patients may aid in the prevention of complications after spine procedures. The ACS NSQIP surgical risk calculator was developed to predict 30-day postoperative complications for a variety of operative procedures. METHODS: Medical records of patients undergoing ALIF at our institution from 2009-2019 were retrospectively reviewed. Demographic and comorbidity variables were entered into the ACS NSQIP surgical risk calculator to generate percentage predictions for complication incidence within 30 days postoperatively. The observed incidences of these complications were also abstracted from the medical record. The predictive ability of the ACS NSQIP surgical risk calculator was assessed in comparison to the observed incidence of complications using area under the curve (AUC) analyses. RESULTS: Two hundred fifty-three (253) patients were analyzed. The ACS NSQIP surgical risk calculator was a fair predictor of discharge to non-home facility (AUC 0.71) and surgical site infection (AUC 0.70). The ACS NSQIP surgical risk calculator was a good predictor of acute kidney injury/progressive renal insufficiency (AUC 0.81). The ACS NSQIP surgical risk calculator was not an adequate predictive tool for any other category, including: pneumonia, urinary tract infections, venous thromboembolism, readmission, reoperations, and aggregate complications (AUC < 0.70). CONCLUSIONS: The ACS NSQIP surgical risk calculator is an adequate predictive tool for a subset of complications after ALIF including acute kidney injury/progressive renal insufficiency, surgical site infections, and discharge to non-home facilities. However, it is a poor predictor for all other complication groups. The reliability of the ACS NSQIP surgical risk calculator is limited, and further identification of models for risk stratification are necessary for patients undergoing ALIF.Level of Evidence: 3.
    Source

    Narain AS, Kitto AZ, Braun B, Poorman MJ, Curtin P, Slavin J, Whalen G, DiPaola CP, Connolly PJ, Stauff MP. Does the ACS NSQIP Surgical Risk Calculator Accurately Predict Complications Rates After Anterior Lumbar Interbody Fusion Procedures? Spine (Phila Pa 1976). 2020 Dec 17;Publish Ahead of Print. doi: 10.1097/BRS.0000000000003893. Epub ahead of print. PMID: 33337678. Link to article on publisher's site

    DOI
    10.1097/BRS.0000000000003893
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29695
    PubMed ID
    33337678
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    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1097/BRS.0000000000003893
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