Evidence map›Paper›PMID 36640606›Full record

ArticleThe Journal of surgical research2023

Preoperative Prediction of Unplanned Reoperation in a Broad Surgical Population.

Emily M Mason, William G Henderson, Michael R Bronsert, Kathryn L Colborn, Adam R Dyas, Helen J Madsen, Anne Lambert-Kerzner, Robert A Meguid

Abstract read
In one paragraph

Article in The Journal of surgical research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Emily M MasonClinical Science Program, University of Colorado Anschutz Medical Campus, Graduate School, Colorado Clinical and Translational Sciences Institute, Aurora, Colorado; Department of Surgery, Surgical Outcomes and Applied Research Program, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado.
William G HendersonDepartment of Surgery, Surgical Outcomes and Applied Research Program, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado; Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Aurora, Colorado.
Michael R BronsertDepartment of Surgery, Surgical Outcomes and Applied Research Program, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado.
Kathryn L ColbornDepartment of Surgery, Surgical Outcomes and Applied Research Program, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado; Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Aurora, Colorado.
Adam R DyasDepartment of Surgery, Surgical Outcomes and Applied Research Program, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado.
Helen J MadsenDepartment of Surgery, Surgical Outcomes and Applied Research Program, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado.
Anne Lambert-KerznerDepartment of Surgery, Surgical Outcomes and Applied Research Program, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado; Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Aurora, Colorado.
Robert A MeguidDepartment of Surgery, Surgical Outcomes and Applied Research Program, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado. Electronic address: Robert.Meguid@cuanschutz.edu.

Funding

NIH Prior Approval Process ProfessionalUL1TR002535 · NCATS · UNIVERSITY OF COLORADO DENVER · PI SOKOL, RONALD J. · 2018 to 2022
$51.1M
NCATS NIH HHS UL1 TR002535
6 · The paper itself

Abstract

introductionUnplanned reoperation is an undesirable outcome with considerable risks and an increasingly assessed quality of care metric. There are no preoperative prediction models for reoperation after an index surgery in a broad surgical population in the literature. The Surgical Risk Preoperative Assessment System (SURPAS) preoperatively predicts 12 postoperative adverse events using 8 preoperative variables, but its ability to predict unplanned reoperation has not been assessed. This study's objective was to determine whether the SURPAS model could accurately predict unplanned reoperation.

methodsThis was a retrospective analysis of the American College of Surgeons' National Surgical Quality Improvement Program adult database, 2012-2018. An unplanned reoperation was defined as any unintended operation within 30 d of an initial scheduled operation. The 8-variable SURPAS model and a 29-variable "full" model, incorporating all available American College of Surgeons' National Surgical Quality Improvement Program nonlaboratory preoperative variables, were developed using multiple logistic regression and compared using discrimination and calibration metrics: C-indices (C), Hosmer-Lemeshow observed-to-expected plots, and Brier scores (BSs). The internal chronological validation of the SURPAS model was conducted using "training" (2012-2017) and "test" (2018) datasets.

resultsOf 5,777,108 patients, 162,387 (2.81%) underwent an unplanned reoperation. The SURPAS model's C-index of 0.748 was 99.20% of that for the full model (C = 0.754). Hosmer-Lemeshow plots showed good calibration for both models and BSs were similar (BS = 0.0264, full; BS = 0.0265, SURPAS). Internal chronological validation results were similar for the training (C = 0.749, BS = 0.0268) and test (C = 0.748, BS = 0.0250) datasets.

conclusionsThe SURPAS model accurately predicted unplanned reoperation and was internally validated. Unplanned reoperation can be integrated into the SURPAS tool to provide preoperative risk assessment of this outcome, which could aid patient risk education.

Indexed as

Postoperative ComplicationsAdultHumansLogistic ModelsReoperationRetrospective StudiesRisk AssessmentRisk FactorsAmerican college of surgeons national surgical quality improvement programChronological validationReoperationRisk predictionSurgical outcomesSurgical risk preoperative assessment system

Identifiers

PMID36640606
PMCPMC9975057

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.