TY - JOUR
T1 - Evaluating the ACS NSQIP Risk Calculator in Primary Pancreatic Neuroendocrine Tumor
T2 - Results from the US Neuroendocrine Tumor Study Group
AU - Dave, Apeksha
AU - Beal, Eliza W.
AU - Lopez-Aguiar, Alexandra G.
AU - Poultsides, George
AU - Makris, Eleftherios
AU - Rocha, Flavio G.
AU - Kanji, Zaheer
AU - Ronnekleiv-Kelly, Sean
AU - Rendell, Victoria R.
AU - Fields, Ryan C.
AU - Krasnick, Bradley A.
AU - Idrees, Kamran
AU - Smith, Paula Marincola
AU - Nathan, Hari
AU - Beems, Megan
AU - Maithel, Shishir K.
AU - Pawlik, Timothy M.
AU - Schmidt, Carl R.
AU - Dillhoff, Mary E.
N1 - Publisher Copyright:
© 2019, The Society for Surgery of the Alimentary Tract.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Background: In a changing health care environment where patient outcomes will be more closely scrutinized, the ability to predict surgical complications is becoming increasingly important. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) online risk calculator is a popular tool to predict surgical risk. This paper aims to assess the applicability of the ACS NSQIP calculator to patients undergoing surgery for pancreatic neuroendocrine tumors (PNETs). Methods: Using the US Neuroendocrine Tumor Study Group (USNET-SG), 890 patients who underwent pancreatic procedures between 1/1/2000–12/31/2016 were evaluated. Predicted and actual outcomes were compared using C-statistics and Brier scores. Results: The most commonly performed procedure was distal pancreatectomy, followed by standard and pylorus-preserving pancreaticoduodenectomy. For the entire group of patients studied, C-statistics were highest for discharge destination (0.79) and cardiac complications (0.71), and less than 0.7 for all other complications. The Brier scores for surgical site infection (0.1441) and discharge to nursing/rehabilitation facility (0.0279) were below the Brier score cut-off, while the rest were equal to or above and therefore not useful for interpretation. Conclusion: This work indicates that the ACS NSQIP risk calculator is a valuable tool that should be used with caution and in coordination with clinical assessment for PNET clinical decision-making.
AB - Background: In a changing health care environment where patient outcomes will be more closely scrutinized, the ability to predict surgical complications is becoming increasingly important. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) online risk calculator is a popular tool to predict surgical risk. This paper aims to assess the applicability of the ACS NSQIP calculator to patients undergoing surgery for pancreatic neuroendocrine tumors (PNETs). Methods: Using the US Neuroendocrine Tumor Study Group (USNET-SG), 890 patients who underwent pancreatic procedures between 1/1/2000–12/31/2016 were evaluated. Predicted and actual outcomes were compared using C-statistics and Brier scores. Results: The most commonly performed procedure was distal pancreatectomy, followed by standard and pylorus-preserving pancreaticoduodenectomy. For the entire group of patients studied, C-statistics were highest for discharge destination (0.79) and cardiac complications (0.71), and less than 0.7 for all other complications. The Brier scores for surgical site infection (0.1441) and discharge to nursing/rehabilitation facility (0.0279) were below the Brier score cut-off, while the rest were equal to or above and therefore not useful for interpretation. Conclusion: This work indicates that the ACS NSQIP risk calculator is a valuable tool that should be used with caution and in coordination with clinical assessment for PNET clinical decision-making.
KW - ACS NSQIP risk calculator
KW - PNET
KW - Pan-NET
KW - Pancreatic neuroendocrine tumor
UR - http://www.scopus.com/inward/record.url?scp=85064524159&partnerID=8YFLogxK
U2 - 10.1007/s11605-019-04120-4
DO - 10.1007/s11605-019-04120-4
M3 - Article
C2 - 30941685
AN - SCOPUS:85064524159
SN - 1091-255X
VL - 23
SP - 2225
EP - 2231
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 11
ER -