Lubitz AL, et al. – Researchers performed this analysis to determine the accuracy of American College of Surgeons–NSQIP Risk Calculator in patients undergoing elective and emergent colorectal operations. The Risk Calculator accurately predicted outcomes for elective colorectal surgery. Significantly increased predicted and actual outcomes were observed in patients undergoing emergent colon operations compared to those undergoing elective procedures. They suggest practicing caution while using the Risk Calculator (RC) in emergent cases, as it has the potential to underestimate serious complications and length of stay (LOS), while overestimating discharge to Skilled Nursing Facility (SNF).

Methods

• Researchers paired 75 patients undergoing emergent colorectal surgery with 75 patients having elective colorectal operations from January 2013 through December 2015.
• They entered patient data into the Risk Calculator (RC).
• Comparison of actual postoperative outcomes, derived from NSQIP data, to those predicted by the RC was performed.

Results

• There appeared differences between emergent and elective patients (p<0.05) regarding age, functional status, ASA class, steroid use, wound class, COPD and chronic renal insufficiency.
• In elective patients, the RC accurately predicted outcomes.
• The emergent operations had significantly worse outcomes (p<0.05).
• The RC underestimated serious complications and LOS and overestimated discharge to a SNF (all p<0.05) in emergent cases.