First American College of Surgeons National Surgical Quality Improvement Program Report from a Low-Middle-Income Country: A 1-Year Outcome Analysis of Neurosurgical Cases

Hussain, Mustafa Mushtaq; Bibi, Farida; Shah, Shafqat H.; Mitha, Rida; Shamim, Muhammad Shahzad; Ziauddin, Afsheen; Zafar, Hasnain

doi:10.1016/j.wneu.2021.08.026

Cited by 2 publications

(2 citation statements)

References 28 publications

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“…Factors like hospital and surgeon volume, healthcare system, and relevant resources are also not considered. When NSQIP standards are implemented in low-middle-income countries, higher rates of adverse events highlight the need for improvement [ 20 ]. Recently, Mehaffey et al showed that socioeconomic factors are independent predictors of postoperative outcomes and should be integrated with the ACS-SRC model [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

External Validation of the American College of Surgeons Surgical Risk Calculator in Elderly Patients Undergoing General Surgery Operations

Kokkinakis

Andreou

Venianaki

et al. 2022

JCM

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Preoperative risk stratification in the elderly surgical patient is an essential part of contemporary perioperative care and can be done with the use of the American College of Surgeons Surgical Risk Calculator (ACS-SRC). However, data on the generalizability of the ACS-SRC in the elderly is scarce. In this study, we report an external validation of the ACS-RC in a geriatric cohort. A retrospective analysis of a prospectively maintained database was performed including patients aged > 65 who underwent general surgery procedures during 2012–2017 in a Greek academic centre. The predictive ability of the ACS-SRC for post-operative outcomes was tested with the use of Brier scores, discrimination, and calibration metrics. 471 patients were included in the analysis. 30-day postoperative mortality was 3.2%. Overall, Brier scores were lower than cut-off values for almost all outcomes. Discrimination was good for serious complications (c-statistic: 0.816; 95% CI: 0.762–0.869) and death (c-statistic: 0.824; 95% CI: 0.719–0.929). The Hosmer-Lemeshow test showed good calibration for all outcomes examined. Predicted and observed length of stay (LOS) presented significant differences for emergency and for elective cases. The ACS-SRC demonstrated good predictive performance in our sample and can aid preoperative estimation of multiple outcomes except for the prediction of post-operative LOS.

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Section: Discussionmentioning

confidence: 99%

External Validation of the American College of Surgeons Surgical Risk Calculator in Elderly Patients Undergoing General Surgery Operations

Kokkinakis

Andreou

Venianaki

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…Adoption of such databases have been even more useful in LMICs where the disease and surgical burden is much greater compared with the developed world. 15 Most of the postoperative complications are related to SSIs in LMICs. More factors such as budget allocation on national level play a pivotal role in the health outcomes; hence, the outcomes from a developing country cannot be at par with that of developed countries.…”

Section: Discussionmentioning

confidence: 99%

Orthopaedic Surgery Complications at a Tertiary Care Hospital in a Low- and Middle-Income Country: A National Surgical Quality Improvement Project Analysis

Hasan,

Ali,

Khan

et al. 2023

JAAOS Glob Res Rev

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Background: Through a comparison of orthopaedic surgical procedures performed at a tertiary care hospital in Pakistan with other participating hospitals of National Surgical Quality Improvement Project (NSQIP), we aim to identify the areas of orthopaedic surgical care at our center that need improvement and also those which are at par with international standards. Methods: The study analyses orthopaedic surgeries at a tertiary care hospital in Pakistan using NSQIP registry to compare complication rates with other American College of Surgeons-NSQIP participant hospitals. Two reviewers collect data in different days every 8 days to reduce bias, and the results are reported in odds ratios using quarterly reports. This study included 584 eligible orthopaedic cases performed in 2021. Yearly institutional reports with odds ratios were also used to identify areas needing improvement and to implement changes to improve orthopaedic surgical outcomes at said institute. Results: The quarterly reports suggest a relatively higher OR for certain indicators such as cardiac events, surgical site infection, mortality, and morbidity throughout. The renal failure rate was very high in the third and fourth quarters with odds ratios of 4.57 and 10.31, respectively. However, the official NSQIP annual institutional report for 2021 identified sepsis, surgical site infections, and cardiac complications as areas ‘needing improvement’. It also indicated that the hospital performed exemplarily when it came to venous thromboembolism (VTE). As for the rest of the indicators, the hospital fell in the ‘as expected’ category of the NSQIP standards. Conclusion: This initial report helps the hospital's orthopaedic department in recognizing areas for improvement and making system-level changes to improve patient outcomes. The implementation of these interventions has yielded favorable outcomes, as evidenced by the findings in the NSQIP yearly report for 2022. Reinforcements and measures are needed to be taken to reduce the adverse events even further and to improve the patient outcomes and quality.

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First American College of Surgeons National Surgical Quality Improvement Program Report from a Low-Middle-Income Country: A 1-Year Outcome Analysis of Neurosurgical Cases

Cited by 2 publications

References 28 publications

External Validation of the American College of Surgeons Surgical Risk Calculator in Elderly Patients Undergoing General Surgery Operations

External Validation of the American College of Surgeons Surgical Risk Calculator in Elderly Patients Undergoing General Surgery Operations

Orthopaedic Surgery Complications at a Tertiary Care Hospital in a Low- and Middle-Income Country: A National Surgical Quality Improvement Project Analysis

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