Optimal perioperative management of the geriatric patient: a best practices guideline from the American College of Surgeons NSQIP
and the American Geriatrics Society.
contains detailed risk modifying information for patient characteristics including International Classification of Disease (ICD) coded diagnosis, medical comorbidities, body mass index, renal function, previous treatments (e.g.
We performed a retrospective analysis of the data in NSQIP
from 2005 to 2012 and chose individuals who underwent open colectomies based on Current Procedural Terminology (CPT) Codes (Table 1).
If the risk is determined to be low--either an RCRI score <2 or an ACS NSQIP
cardiac complication risk <1%--the patient can be referred to surgery without further evaluation.
The information incorporated into the NSQIP
database is extracted from patient medical records, physician office records, and telephone interviews by trained surgical clinical nurse reviewers (SCNRs).
For ACS NSQIP
, BMI has minimal association with short-term operative outcomes after major cancer surgery .
collects data on well over 100 variables per case, making it possible to use detailed multivariate logistic regression analyses to identify independent preoperative predictors of postoperative pneumonia.
(16.) Davenport DL, Henderson WG, Khuri SF, Mentzer RM, Jr.: Preoperative risk factors and surgical complexity are more predictive of costs than postoperative complications: A case study using the National Surgical Quality Improvement Program (NSQIP
In the United States, the National Surgical Quality Improvement Program (NSQIP
database with over a million patients) defines emergency surgery as surgery performed within 12 hours of presenting to hospital or developing symptoms (21).
In additionally, Khuri led a unique national effort within the VA that established the National Surgical Quality Improvement Program (NSQIP
), now recognized by the surgical community as the standard for the comparative assessment of quality of surgical care and for continuous improvement in surgery.
He led the expansion of the National Surgical Quality Improvement Program (NSQIP
) from the Veterans Administration to the private sector, and then used that experience to design and develop the Michigan Surgical Quality Collaborative (MSQC), a quality collaborative based on NSQIP
There are several systems used for the scoring of surgical patients: the American Society of Anesthesiology classification (5), Revised Cardiac Risk index (6), Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (7) score and the National Surgical Quality Improvement Programme (NSQIP
) (8) score.