Successful Implementation of the Department of Veterans Affairs’ National Surgical Quality Improvement Program in the Private Sector: The Patient Safety in Surgery Study

Khuri, Shukri F.; Henderson, William G.; Daley, Jennifer; Jonasson, Olga; Jones, R. Scott; Campbell, Darrell A.; Fink, Aaron S.; Mentzer, Robert M.; Neumayer, Leigh; Hammermeister, Karl E.; Mosca, Cecilia; Healey, Nancy A.

doi:10.1097/sla.0b013e3181823485

Cited by 530 publications

(278 citation statements)

References 10 publications

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“…The published incidence of adverse events among patients with gynaecological cancer varies from 26% to 54% (13,14) and some studies suggest that a significant portion of AEs are preventable (15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

Kondalsamy‐Chennakesavan

Janda

Gebski

et al. 2012

European Journal of Cancer

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Aims: To identify risk factors for major Adverse Events (AEs) and to develop a nomogram to predict the probability of such AEs in individual patients who have surgery for apparent early stage endometrial cancer. Methods:We used data from 753 patients who were randomized to either total laparoscopic hysterectomy or total abdominal hysterectomy in the LACE trial. Serious adverse events that prolonged hospital stay or postoperative adverse events (using common terminology criteria 3+, CTCAE V3) were considered major AEs. We analyzed pre-surgical characteristics that were associated with the risk of developing major AEs by multivariate logistic regression.We identified a parsimonious model by backward stepwise logistic regression. The six most significant or clinically important variables were included in the nomogram to predict the risk of major AEs within 6 weeks of surgery and the nomogram was internally validated.Results: Overall, 132 (17.5%) patients had at least one major AE. An open surgical approach (laparotomy), higher Charlson's medical co-morbidities score, moderately differentiated tumours on curettings, higher baseline ECOG score, higher body mass index and low haemoglobin levels were associated with AE and were used in the nomogram. The bootstrap corrected concordance index of the nomogram was 0.63 and it showed good calibration. Conclusions:Six pre-surgical factors independently predicted the risk of major AEs. This research might form the basis to develop risk reduction strategies to minimize the risk of AEs among patients undergoing surgery for apparent early stage endometrial cancer. Clinical Trial Registration: NCT00096408

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Section: Discussionmentioning

confidence: 99%

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

Kondalsamy‐Chennakesavan

Janda

Gebski

et al. 2012

European Journal of Cancer

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“…Patient variables from more than 250 participating institutions nationwide are included in the ACS NSQIP 1 , and this database has been used to analyze trends and associations in orthopaedic surgery [15,17,28]. The method of data abstraction from the ACS NSQIP 1 participant files has been described [4,18]. Patients were identified through Current Procedural Terminology (CPT) codes and included patients undergoing TKA (CPT 27447), THA (CPT 27130), single-level posterior or posterolateral lumbar fusion (CPT 22612 with no CPT modifiers), multilevel posterior or posterolateral lumbar fusion (CPT 22612 with a CPT modifier of 22614), single-level anterior cervical discectomy and fusion (CPT 22551 with no CPT modifiers), multilevel anterior cervical discectomy and fusions (CPT 22612 with a CPT modifier of 22552), and total shoulder arthroplasty (CPT 23472).…”

Section: Methodsmentioning

confidence: 99%

What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery?

Minhas

Goyal

Patel

2016

Clinical Orthopaedics &Amp; Related Research

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Background Perioperative cerebrovascular accidents (CVAs) are one of the leading causes of patient morbidity, mortality, and medical costs. However, little is known regarding the rates of these events and risk factors for CVA after elective orthopaedic surgery. Questions/purposes Our goals were to (1) establish the national, baseline proportion of patients experiencing a 30-day CVA and the timing of CVA; and (2) determine independent risk factors for 30-day CVA rates after common elective orthopaedic procedures. Methods Patients undergoing elective TKA, THA, posterior or posterolateral lumbar fusion, anterior cervical discectomy and fusion, and total shoulder arthroplasty, from 2006 to 2012, were identified from the American College of Surgeons National Surgical Quality Improvement Program 1 database. A total of 42,150 patients met inclusion criteria. Thirty-day CVA rates were recorded for each procedure, and patients were assessed for characteristics associated with CVA through univariate analysis. Multivariate regression models were created to identify independent risk factors for CVA. Results A total of 55 (0.13%) patients experienced a CVA within 30 days of the procedure, occurring a median of 2 days after surgery (range, 1-30 days) with 0.08% of patients experiencing a CVA after TKA, 0.15% after THA, 0.00% after single-level anterior cervical discectomy and fusion, 0.38% after multilevel anterior cervical discectomy and fusions, 0.20% after single-level posterior or posterolateral lumbar fusion, 0.70% after multilevel posterior or posterolateral lumbar fusion, and 0.22% after total shoulder arthroplasty. Independent risk factors for CVA included age of 75 years or older (odds ratio [OR], 2.50; 95% CI,

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“…These patients are prospectively identified and randomly sampled from eligible hospitals in a manner designed by the ACS-NSQIP 1 to minimize selection bias. Data collection occurs for each patient's entire 30-day postoperative period, regardless of the date of discharge after surgery [2,15].…”

Section: Study Design and Settingmentioning

confidence: 99%

Diabetes Confers Little to No Increased Risk of Postoperative Complications After Hip Fracture Surgery in Geriatric Patients

Golinvaux

Bohl

Basques

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Successful Implementation of the Department of Veterans Affairs’ National Surgical Quality Improvement Program in the Private Sector: The Patient Safety in Surgery Study

Abstract: The VA NSQIP methods and risk models in general and vascular surgery were fully applicable to PS hospitals. Thirty-day postoperative morbidity in PS hospitals was reduced with the implementation of the NSQIP.

Cited by 530 publications

References 10 publications

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery?

Diabetes Confers Little to No Increased Risk of Postoperative Complications After Hip Fracture Surgery in Geriatric Patients

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