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Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons
57th Annual Meeting Abstracts


Presentation #1

Abstract Title

Improving Outcomes at National Surgical Quality Improvement Program Utilizing Centers, 2005-2008

Author Block

Deepak K. Ozhathil, MD YouFu Li, MD, Margaret M. Hudlin, MD, Jillian K. Smith, MD, Jennifer F. Tseng, MD, Shimul A. Shah, MD
Department of Surgery University of Massachusetts Medical School, Worcester, MA

Abstract Body

Background: Participation in ACS-NSQIP has increased annually since 2004 and the program continues to achieve success as a method of prospective data analysis. As we continue to better understand the link between data comprehension and clinical improvement, we sought to determine if performance improvement was observed among all participating institutions from 2005-2008.

Methods: We queried records from ACS-NSQIP (2005-2008) for all adults (≥18 years) who underwent inpatient procedures, including emergent and elective cases. Operating room times and number of PRBC units transfused were analyzed as intra-operative variables. Primary outcomes measured morbidity, mortality and length of stay (LOS). Independently analyzed postoperative complications included SSI, wound disruption, post-operative pneumonia, unplanned reintubations, MI, DVT, renal insufficiency, ARF, UTI, graft failure, sepsis and septic shock.

Results: 412,135 cases were sorted by operative year. Risk adjusted morbidity and mortality decreased over time (p<0.0001). Specific post-operative complication trends showed significant improvement over time (Figure): superficial SSI (p<0.0001), deep SSI (p<0.0001), organ SSI (p<0.02), wound disruption (p<0.0001), pneumonia (p<0.0001), reintubations (p<0.0001), ARF (p<0.0001), UTI (p<0.0001), graft failure (p<0.0001), sepsis (p<0.0001), septic shock (p<0.0001), operative time (p<0.0001), LOS (p<0.0001) and PRBC transfusions (p<0.0001).

Conclusion: Enrollment in ACS NSQIP parallels improvement across multiple performance indicators, which is evident now only four years since its inception. This data confirms that increased participation in NSQIP is warranted due to improvements in surgical performance and the potential for reduced healthcare costs.

 

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