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Development and Evaluation of the American College of Surgeons NSQIP Pediatric Surgical Risk Calculator.
- Source :
-
Journal of the American College of Surgeons . Nov2016, Vol. 223 Issue 5, p685-693. 9p. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>There is an increased desire among patients and families to be involved in the surgical decision-making process. A surgeon's ability to provide patients and families with patient-specific estimates of postoperative complications is critical for shared decision making and informed consent. Surgeons can also use patient-specific risk estimates to decide whether or not to operate and what options to offer patients. Our objective was to develop and evaluate a publicly available risk estimation tool that would cover many common pediatric surgical procedures across all specialties.<bold>Study Design: </bold>American College of Surgeons NSQIP Pediatric standardized data from 67 hospitals were used to develop a risk estimation tool. Surgeons enter 18 preoperative variables (demographics, comorbidities, procedure) that are used in a logistic regression model to predict 9 postoperative outcomes. A surgeon adjustment score is also incorporated to adjust for any additional risk not accounted for in the 18 risk factors.<bold>Results: </bold>A pediatric surgical risk calculator was developed based on 181,353 cases covering 382 CPT codes across all specialties. It had excellent discrimination for mortality (c-statistic = 0.98), morbidity (c-statistic = 0.81), and 7 additional complications (c-statistic > 0.77). The Hosmer-Lemeshow statistic and graphic representations also showed excellent calibration.<bold>Conclusions: </bold>The ACS NSQIP Pediatric Surgical Risk Calculator was developed using standardized and audited multi-institutional data from the ACS NSQIP Pediatric, and it provides empirically derived, patient-specific postoperative risks. It can be used as a tool in the shared decision-making process by providing clinicians, families, and patients with useful information for many of the most common operations performed on pediatric patients in the US. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PEDIATRIC surgery
*PEDIATRIC surgeons
*PATIENTS' families
*MEDICAL decision making
*SURGICAL complications
*PREOPERATIVE risk factors
*COMPARATIVE studies
*DECISION making
*HEALTH status indicators
*RESEARCH methodology
*MEDICAL cooperation
*MEDICAL societies
*MEDICAL specialties & specialists
*PEDIATRICS
*PREOPERATIVE care
*RESEARCH
*RISK assessment
*OPERATIVE surgery
*PATIENT participation
*LOGISTIC regression analysis
*EVALUATION research
SURGERY practice
Subjects
Details
- Language :
- English
- ISSN :
- 10727515
- Volume :
- 223
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Journal of the American College of Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 118922797
- Full Text :
- https://doi.org/10.1016/j.jamcollsurg.2016.08.542