Does one score fit all? Measuring risk in ulcerative colitis

Deborah S. Keller, Kyle G. Cologne, Anthony J. Senagore, Eric M. Haas

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The American College of Surgeons Surgical Risk Calculator was developed to improve risk stratification and surgical quality but has not been studied at the institutional level for specific disease states, like ulcerative colitis (UC). Methods: UC patients undergoing colorectal resection had predicted risk calculator data compared with actual outcomes for length of stay (LOS), complications, reoperation, and death. Main outcome measures were the difference in actual vs predicted outcomes. Results: Seventy patients were evaluated. The actual and predicted mean LOS was identical, but not representative of the actual LOS picture, which had 10 LOS outliers (14.3%). The actual incidence of any complication (P <.001) and major complications (P <.001) was higher than predicted. The most common complications actually encountered-intrabdominal abscess (14.3%), postoperative ileus (7.2%), and anastomotic leak (5.7%), were not even calculated by the tool. Conclusions: For UC, the calculator poorly evaluates relevant risks, complications, and is greatly impacted by outliers. These limitations caution use for surgical quality reporting and determining specific patient outcomes, at least in UC.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jun 15 2015
Externally publishedYes

Fingerprint

Ulcerative Colitis
Length of Stay
Anastomotic Leak
Ileus
Reoperation
Abscess
Outcome Assessment (Health Care)
Incidence

Keywords

  • ACS Surgical Risk Calculator
  • Inflammatory bowel disease
  • Laparoscopic colorectal surgery
  • NSQIP
  • Patient outcomes
  • Quality measures

ASJC Scopus subject areas

  • Surgery

Cite this

Does one score fit all? Measuring risk in ulcerative colitis. / Keller, Deborah S.; Cologne, Kyle G.; Senagore, Anthony J.; Haas, Eric M.

In: American Journal of Surgery, 15.06.2015.

Research output: Contribution to journalArticle

Keller, Deborah S. ; Cologne, Kyle G. ; Senagore, Anthony J. ; Haas, Eric M. / Does one score fit all? Measuring risk in ulcerative colitis. In: American Journal of Surgery. 2015.
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