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World Journal of Surgery
Published in: World Journal of Surgery 1/2017

01-01-2017 | Original Scientific Report

An Online Tool for Global Benchmarking of Risk-Adjusted Surgical Outcomes

Authors: Richard T. Spence, David C. Chang, Kathryn Chu, Eugenio Panieri, Jessica L. Mueller, Matthew M. Hutter

Published in: World Journal of Surgery | Issue 1/2017

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Abstract

Background

Increasing evidence demonstrates significant variation in adverse outcomes following surgery between countries. In order to better quantify these variations, we hypothesize that freely available online risk calculators can be used as a tool to generate global benchmarking of risk-adjusted surgical outcomes.

Methods

This is a prospective cohort study conducted at an academic teaching hospital in South Africa (GSH). Consecutive adult patients undergoing major general or vascular surgery who met the ACS-NSQIP inclusion criteria for a 3-month period were included. Data variables required by the ACS risk calculator were prospectively collected, and patients were followed for 30 days post-surgery for the occurrence of endpoints. Calculating observed-to-expected ratios for ten outcome measures of interest generated risk-adjusted outcomes benchmarked against the ACS-NSQIP consortium.

Results

A total of 373 major general and vascular surgery procedures met the inclusion criteria. The GSH operative cohort varied significantly compared to the 2012 ACS-NSQIP database. The risk-adjusted O/E ratios were significant for any complication O/E 1.91 (95 % CI 1.57–2.31), surgical site infections O/E 4.76 (95 % CI 3.71–6.01), renal failure O/E 3.29 (95 % CI 1.50–6.24), death O/E 3.43 (95 % CI 2.19–5.11), and total length of stay (LOS) O/E 3.43 (95 % CI 2.19–5.11).

Conclusion

Freely available online risk calculators can be utilized as tools for global benchmarking of risk-adjusted surgical outcomes.
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Metadata
Title
An Online Tool for Global Benchmarking of Risk-Adjusted Surgical Outcomes
Authors
Richard T. Spence
David C. Chang
Kathryn Chu
Eugenio Panieri
Jessica L. Mueller
Matthew M. Hutter
Publication date
01-01-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 1/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-016-3668-x

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