Outcomes analysis of microsurgical physiologic lymphatic procedures for the upper extremity from the United States National Surgical Quality Improvement Program

Microsurgery ◽  
2021 ◽  
Author(s):  
Ravinder Bamba ◽  
Amanda Chu ◽  
Jose Gallegos ◽  
Fernando A. Herrera ◽  
Aladdin H. Hassanein
Keyword(s):  
United States ◽  
Quality Improvement ◽  
Upper Extremity ◽  
The United States ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Outcomes Analysis ◽  
Surgical Quality

Accuracy of the ACS NSQIP Online Risk Calculator Depends on How You Look at It: Results from the United States Gastric Cancer Collaborative

2018 ◽  
Vol 84 (3) ◽  
pp. 358-364 ◽  
Author(s):  
Eliza W. Beal ◽  
Neil D. Saunders ◽  
Joseph F. Kearney ◽  
Ezra Lyon ◽  
Lai Wei ◽  
...  
Keyword(s):  
United States ◽  
Gastric Cancer ◽  
Quality Improvement ◽  
The United States ◽  
Quality Improvement Program ◽  
Risk Calculator ◽  
Improvement Program ◽  
Surgical Quality ◽  
Online Risk ◽  
American College Of Surgeons

The objective of this study is to assess the accuracy of the American College of Surgeons National Surgical Quality Improvement Program online risk calculator for estimating risk after operation for gastric cancer using the United States Gastric Cancer Collaborative. Nine hundred and sixty-five patients who underwent resection of gastric adenocarcinoma between January 2000 and December 2012 at seven academic medical centers were included. Actual complication rates and outcomes for patients were compared. Most of the patients underwent total gastrectomy with Roux-en-Y reconstruction (404, 41.9%) and partial gastrectomy with gastrojejunostomy (239, 24.8%) or Roux-en-Y reconstruction (284, 29.4%). The C-statistic was highest for venous throm-boembolism (0.690) and lowest for renal failure at (0.540). All C-statistics were less than 0.7. Brier scores ranged from 0.010 for venous thromboembolism to 0.238 for any complication. General estimates of risk for the cohort were variable in terms of accuracy. Improving the ability of surgeons to estimate preoperative risk for patients is critically important so that efforts at risk reduction can be personalized to each patient. The American College of Surgeons National Surgical Quality Improvement Program risk calculator is a rapid and easy-to-use tool and validation of the calculator is important as its use becomes more common.

Upper Extremity Free Flap Transfers: An Analysis of the National Surgical Quality Improvement Program Database

2020 ◽  
Author(s):  
George A. Beyer ◽  
Karan Dua ◽  
Neil V. Shah ◽  
Joseph P. Scollan ◽  
Jared M. Newman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Upper Extremity ◽  
Free Flap ◽  
Quality Improvement Program ◽  
Readmission Rates ◽  
Improvement Program ◽  
Surgical Quality ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Reoperation Rates

Abstract Introduction We evaluated the demographics, flap types, and 30-day complication, readmission, and reoperation rates for upper extremity free flap transfers within the National Surgical Quality Improvement Program (NSQIP) database. Materials and Methods Upper extremity free flap transfer patients in the NSQIP from 2008 to 2016 were identified. Complications, reoperations, and readmissions were queried. Chi-squared tests evaluated differences in sex, race, and insurance. The types of procedures performed, complication frequencies, reoperation rates, and readmission rates were analyzed. Results One-hundred-eleven patients were selected (mean: 36.8 years). Most common upper extremity free flaps were muscle/myocutaneous (45.9%) and other vascularized bone grafts with microanastomosis (27.9%). Thirty-day complications among all patients included superficial site infections (2.7%), intraoperative transfusions (7.2%), pneumonia (0.9%), and deep venous thrombosis (0.9%). Thirty-day reoperation and readmission rates were 4.5% and 3.6%, respectively. The mean time from discharge to readmission was 12.5 days. Conclusion Upper extremity free flap transfers could be performed with a low rate of 30-day complications, reoperations, and readmissions.

National Pediatric Anesthesia Safety Quality Improvement Program in the United States

2014 ◽  
Vol 119 (1) ◽  
pp. 112-121 ◽  
Author(s):  
C. Dean Kurth ◽  
Don Tyler ◽  
Eugenie Heitmiller ◽  
Steven R. Tosone ◽  
Lynn Martin ◽  
...  
Keyword(s):  
United States ◽  
Quality Improvement ◽  
Pediatric Anesthesia ◽  
The United States ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Anesthesia Safety

Comparing Plastic Surgeon Versus Orthopedic Surgeon Outcomes Following Distal Upper Extremity Amputations: A Study of the National Surgical Quality Improvement Program (NSQIP) Database

2020 ◽  
pp. 229255032094783
Author(s):  
Jerry Y. Du ◽  
Joanne H. Wang ◽  
Cristin L. Coquillard ◽  
Anand R. Kumar ◽  
Kevin J. Malone
Keyword(s):  
Quality Improvement ◽  
Upper Extremity ◽  
Perioperative Complications ◽  
Univariate Analysis ◽  
Wound Dehiscence ◽  
Quality Improvement Program ◽  
Perioperative Outcomes ◽  
Improvement Program ◽  
Surgical Quality ◽  
Orthopedic Surgeons

Background: Both plastic and orthopedic surgeons manage care for urgent/emergent hand conditions. It is unclear if surgeon specialty affects patient outcomes of these cases. The purpose of this study was to evaluate differences in 30-day perioperative outcomes between plastic and orthopedic surgeons following distal upper extremity amputations. Methods: Patients who underwent distal upper extremity amputations between 2005 and 2016 were identified within the National Surgical Quality Improvement Program (NSQIP) database using Current Procedural Terminology ( CPT) codes. Differences in operative procedures, patient demographics, patient comorbidities, and 30-day perioperative complications were compared between orthopedic and plastic surgeons by univariate analysis. A Bonferroni correction was applied to account for multiple comparisons of complications. Results: A total of 1583 cases met inclusion criteria. Orthopedic surgeons performed 981 cases (62.0%) and plastic surgeons performed 602 cases (38.0%). Finger amputations comprised the majority of procedures for both orthopedic and plastic surgeons (95.5% and 94.4%, respectively). Orthopedic surgeons had a lower operative time (41.7 ± 36.2 minutes vs 47.1 ± 40.9 minutes, P = .008). There were no differences in proportion of emergency surgery, inpatients, or wound class. There were no differences in age, gender, or body mass index. The most common indications for amputation were trauma, gangrene, and osteomyelitis. There were no differences between surgical specialties in 18 30-day perioperative complications assessed, including death, reoperation, surgical site infection, or wound dehiscence. Conclusions: Plastic and orthopedic surgeons achieved equivalent outcomes comparing 30-day perioperative complications following upper extremity amputations. These results support that both orthopedic and plastic surgeons provide similar quality distal upper extremity amputation care.

Upper Extremity Bypass for Chronic Ischemia—A National Surgical Quality Improvement Program Study Database Study

2013 ◽  
Vol 47 (3) ◽  
pp. 192-194 ◽  
Author(s):  
Kakra Hughes ◽  
Maricel Cubangbang ◽  
Kwesi Blackman ◽  
Oluwaseyi Bolorunduro ◽  
David A. Rose ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Upper Extremity ◽  
Quality Improvement Program ◽  
Chronic Ischemia ◽  
Improvement Program ◽  
Surgical Quality ◽  
Database Study ◽  
Study Database

National Pediatric Anesthesia Safety Quality Improvement Program in the United States

2015 ◽  
Vol 59 (1) ◽  
pp. 36-37
Author(s):  
C. Dean Kurth ◽  
Don Tyler ◽  
Eugenie Heitmiller ◽  
Steven R. Tosone ◽  
Lynn Martin ◽  
...  
Keyword(s):  
United States ◽  
Quality Improvement ◽  
Pediatric Anesthesia ◽  
The United States ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Anesthesia Safety
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