ORLANDO, FL USA (UroToday.com) - The National Surgical Quality Improvement Project (NSQIP) Surgical Risk calculator is a tool that the American College of Surgeons created to estimate the risk of peri-operative outcomes for common surgical procedures in order to improve quality. Jeffrey Tomaszewski and colleagues wanted to evaluate the accuracy of the calculator in patients treated with radical cystectomy for urothelial carcinoma.
For the study, the authors utilized a prospectively maintained database of radical cystectomy patients from 2007-2011. Twenty-two preoperative risk factors were entered into the NSQIP calculator for each patient to obtain 30-day mortality, post-operative complications, and length of stay at the hospital. The authors compared observed vs. expected events for the patients in the database.
They included 314 patients in their analysis and found that the NSQIP calculator significantly underestimated risk of death, serious complications, overall complications, surgical site infections, urinary tract infections, acute renal failure and hospital length of stay.
The authors concluded that patients who underwent radical cystectomy had significant differences in events observed vs those expected using the NSQIP calculator. Given the underestimation of complications using the NSQIP calculator, the authors also concluded that hospitals will likely improve the accuracy of the surgical risk calculator by creating and incorporating procedure specific pre-operative risk factors and outcomes. The use of a calculator to assess the risk of patients undergoing radical cystectomy is beneficial in that it will allow the patient to fully understand, at a preoperative visit, the risks of complications during radical cystectomy.
Presented by Jeffrey Tomaszewski, MD at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA
Fox Chase Cancer Center, Philadelphia, PA USA
Click HERE to view the poster from this session
Written by Garen Abedi, MD, University of California (Irvine), and medical writer for UroToday.com