ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2020
Evaluation of the ACS NSQIP Surgical Risk Calculator in Elderly Patients Undergoing Hepatectomy for Hepatocellular Carcinoma.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 44 citations in OpenAlex.
- One-Year Mortality after Hepatectomy: Defining a Novel Quality Metric.Annals of surgical oncology · 2026Article
- Perioperative Cardiovascular Outcomes and Risk Assessment in Older Adults for Noncardiac Surgery.Current anesthesiology reports · 2025Article
- Validation of the ACS-NSQIP surgical risk calculator for patients with paraoesophageal hernias undergoing robotic repair.Surgical endoscopy · 2025Article
- Predictive value of the American college of surgeons "surgical risk calculator" (ACS-NSQIP SRC) for plastic and reconstructive surgery: a validation study from an academic tertiary referral center in Germany.Patient safety in surgery · 2025Article
- Development and validation of an EHR-based risk prediction model for geriatric patients undergoing urgent and emergency surgery.BMC anesthesiology · 2025Article
- Perioperative inflammatory index differences between pulmonary squamous cell carcinoma and adenocarcinoma and their prognostic implications.Frontiers in oncology · 2025Article
- Effect of Frailty on Postoperative Outcomes Following Major Abdominal Surgeries: A Prospective Observational Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Evaluation of the American College of Surgeons risk calculator in hepatectomy for metastatic colorectal cancer in a Southeast Asian population.Langenbeck's archives of surgery · 2024Article
- Evaluation of the ACS NSQIP surgical risk calculator in patients undergoing common bile duct exploration.Langenbeck's archives of surgery · 2023Article
- Tumor cell-induced platelet aggregation accelerates hematogenous metastasis of malignant melanoma by triggering macrophage recruitment.Journal of experimental & clinical cancer research : CR · 2023Article
- Evaluation of the ACS-NSQIP Surgical Risk Calculator in Patients with Hepatic Metastases from Colorectal Cancer Undergoing Liver Resection.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Preparing for participation in the centers for Medicare and Medicaid Services' bundle care payment initiative-advanced for major bowel surgery.Perioperative medicine (London, England) · 2022Article
- The American College of Surgeons Surgical Risk Calculator performs well for pulmonary resection: A validation study.The Journal of thoracic and cardiovascular surgery · 2022Article
- Timing and Severity of Postoperative Complications and Associated 30-Day Mortality Following Hepatic Resection: a National Surgical Quality Improvement Project Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Impact of Perioperative Thromboembolic Complications on Future Long-term Risk of Venous Thromboembolism among Medicare Beneficiaries Undergoing Complex Gastrointestinal Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Survival Benefit of Primary Tumor Resection Among Elderly Patients with Pancreatic Neuroendocrine Tumors.World journal of surgery · 2021Article
- A simple scoring system to estimate perioperative mortality following liver resection for primary liver malignancy-the Hepatectomy Risk Score (HeRS).Hepatobiliary surgery and nutrition · 2021Article
- Development and validation of a risk calculator for post-discharge venous thromboembolism following hepatectomy for malignancy.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2021Article
- Machine learning predicts unpredicted deaths with high accuracy following hepatopancreatic surgery.Hepatobiliary surgery and nutrition · 2021Article
- Platelets in aging and cancer-"double-edged sword".Cancer metastasis reviews · 2020Review
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Authors and funding
20 authors at 11 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) surgical risk calculator (SRC) aims to help predict patient-specific risk for morbidity and mortality. The performance of the SRC among an elderly population undergoing curative-intent hepatectomy for hepatocellular carcinoma (HCC) remains unknown.
methodsPatients > 70 years of age who underwent hepatectomy for HCC between 1998 and 2017 were identified using a multi-institutional international database. To estimate the performance of SRC, 12 observed postoperative outcomes were compared with median SRC-predicted risk, and C-statistics and Brier scores were calculated.
resultsAmong 500 patients, median age was 75 years (IQR 72-78). Most patients (n = 324, 64.8%) underwent a minor hepatectomy, while 35.2% underwent a major hepatectomy. The observed incidence of venous thromboembolism (VTE) (3.2%) and renal failure (RF) (4.4%) exceeded the median predicted risk (VTE, 1.8%; IQR 1.5-3.1 and RF, 1.0%; IQR 0.5-2.0). In contrast, the observed incidence of 30-day readmission (7.0%) and non-home discharge (2.5%) was lower than median-predicted risk (30-day readmission, 9.4%; IQR 7.4-12.8 and non-home discharge, 5.7%; IQR 3.3-11.7). Only 57.8% and 71.2% of patients who experienced readmission (C-statistic, 0.578; 95%CI 0.468-0.688) or mortality (C-statistic, 0.712; 95%CI 0.508-0.917) were correctly identified by the model.
conclusionAmong elderly patients undergoing hepatectomy for HCC, the SRC underestimated the risk of complications such as VTE and RF, while being no better than chance in estimating the risk of readmission. The ACS SRC has limited clinical applicability in estimating perioperative risk among elderly patients being considered for hepatic resection of HCC.
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