Performance of the American College of Surgeons NSQIP Surgical Risk Calculator for total gastrectomy Journal Article


Authors: Vos, E. L.; Russo, A. E.; Hohmann, A.; Yoon, S. S.; Coit, D. G.; Ko, C. Y.; Strong, V. E.
Article Title: Performance of the American College of Surgeons NSQIP Surgical Risk Calculator for total gastrectomy
Abstract: Background: To encourage implementation of the American College of Surgeons (ACS) NSQIP Risk Calculator for total gastrectomy for gastric cancer, its predictive performance for this specific procedure should be validated. We assessed its discriminatory accuracy and goodness of fit for predicting 12 adverse outcomes. Study Design: Data were collected on all patients with gastric cancer who underwent total gastrectomy with curative intent at Memorial Sloan Kettering Cancer Center between 2002 and 2017. Preoperative risk factors from the electronic medical record were manually inserted into the ACS-NSQIP Risk Calculator. Predictions for adverse outcomes were compared with observed outcomes by Brier scores, c-statistics, and Hosmer-Lemeshow p value. Results: In a total of 452 patients, the predicted rate of all complications (29%) was lower than the observed rate (45%). Brier scores varied between 0.017 for death and 0.272 for any complication. C-statistics were moderate (0.7–0.8) for death and renal failure, good (0.8–0.9) for cardiac complication, and excellent (≥0.9) for discharge to nursing or rehabilitation facility. Hosmer-Lemeshow p value found poor goodness of fit for pneumonia only. Conclusions: For adverse outcomes after total gastrectomy with curative intent in gastric cancer patients, performance of the ACS-NSQIP Risk Calculator is variable. Its predictive performance is best for cardiac complications, renal failure, death, and discharge to nursing or rehabilitation facility. © 2020 American College of Surgeons
Journal Title: Journal of the American College of Surgeons
Volume: 231
Issue: 6
ISSN: 1072-7515
Publisher: Elsevier Science, Inc.  
Date Published: 2020-12-01
Start Page: 650
End Page: 656
Language: English
DOI: 10.1016/j.jamcollsurg.2020.09.023
PUBMED: 33022399
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 December 2020 -- Source: Scopus
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Citation Impact
MSK Authors
  1. Sam Yoon
    90 Yoon
  2. Vivian Strong
    189 Strong
  3. Daniel Coit
    495 Coit
  4. Ashley Elizabeth Russo
    16 Russo
  5. Elvira Lise Vos
    9 Vos