Timed Stair Climbing Is the Single Strongest Predictor of Perioperative Complications in Patients Undergoing Abdominal Surgery Sushanth Reddy, MD, FACS,

Slides:

Advertisements

Similar presentations

How surgeons can find information online? Martin Hewitt International Journal of Surgery Volume 5, Issue 6, Pages (December 2007) DOI: /j.ijsu

Advertisements

Society of Thoracic Surgeons 2008 cardiac risk models predict in-hospital mortality of heart valve surgery in a Chinese population: A multicenter study

The Hartford Consensus: Survey of the Public and Healthcare Professionals on Active Shooter Events in Hospitals Lenworth M. Jacobs, MD, MPH, FACS, Karyl.

Standardization of Care: Impact of an Enhanced Recovery Protocol on Length of Stay, Complications, and Direct Costs after Colorectal Surgery Robert H.

Lenworth M. Jacobs, MD, MPH, FACS, Karyl J

Susanna L. Matsen, MD, Bruce A. Perler, MD, MBA, David C

Operative variables are better predictors of postdischarge infections and unplanned readmissions in vascular surgery patients than patient characteristics

Trend in Volume of Urologic Prosthetic Surgery after Initiation of Prostate Cancer Survivorship Program Alison M. Rasper, MD, Kara E. McAbee, MD, Marc.

Simple Suturing Technique for Umbilical Dimple Wound after Single-Incision Laparoscopic Surgery Yoichi Matsui, MD, PhD, Sohei Satoi, MD, PhD, FACS, Satoshi.

Procedure-Specific Trends in Surgical Outcomes

Exploring the Relationship Between Stereotype Perception and Residents' Well-Being Arghavan Salles, MD, PhD, Claudia M. Mueller, PhD, MD, FACS, Geoffrey.

Michael T. Kassin, MD, Rachel M. Owen, MD, Sebastian D

Mary J. Edwards, MD, FACS, Michael Lustik, MS, Mark W

Preoperative Standard Oral Nutrition Supplements vs Immunonutrition: Results of a Systematic Review and Meta-Analysis Refaat A. Hegazi, MD, PhD, MPH,

Liver Transplantation for Severe Alcoholic Hepatitis, Updated Lessons from the World’s Largest Series Sharon R. Weeks, MD, Zhaoli Sun, MD, PhD, Mary.

Simple Suturing Technique for Umbilical Dimple Wound after Single-Incision Laparoscopic Surgery Yoichi Matsui, MD, PhD, Sohei Satoi, MD, PhD, FACS, Satoshi.

Bouffant vs Skull Cap and Impact on Surgical Site Infection: Does Operating Room Headwear Really Matter? Shanu N. Kothari, MD, FACS, Madeline J. Anderson,

Introduction of Mechanical Sphincter Augmentation for Gastroesophageal Reflux Disease into Practice: Early Clinical Outcomes and Keys to Successful Adoption

Validation of New Readmission Data in the American College of Surgeons National Surgical Quality Improvement Program Morgan M. Sellers, BA, Ryan P. Merkow,

Are Surgeons Being Paid Fairly by Medicaid

Frailty as a Predictor of Surgical Outcomes in Older Patients

Nicholas H. Osborne, MD, MS, Clifford Y. Ko, MD, MS, Gilbert R

A Patient-Centered Early Warning System to Prevent Readmission after Colorectal Surgery: A National Consensus Using the Delphi Method Linda T. Li, MD,

Micah E. Girotti, MD, Clifford Y. Ko, MD, MS, MSHS, Justin B

Perceived Complexity of Various Liver Resections: Results of a Survey of Experts with Development of a Complexity Score and Classification Major K. Lee,

Robert S. Venick, MD, Douglas G. Farmer, MD, FACS, Jose R

Creating Individual Surgeon Performance Assessments in a Statewide Hospital Surgical Quality Improvement Collaborative Christopher M. Quinn, MS, Karl.

Racial and Regional Disparities in the Effect of the Affordable Care Act's Dependent Coverage Provision on Young Adult Trauma Patients John W. Scott,

Assessing surgical risk for adults with congenital heart disease: Are pediatric scoring systems appropriate? Brian Kogon, MD, Matthew Oster, MD, MPH

A Novel Approach to Calculating Small Intestine Length Based on Magnetic Resonance Enterography Nicole A. Wilson, PhD, MD, Hyung-Soon Park, PhD, Kyoung.

Gastric Perforation Associated with Bilateral Inguinal Hernias

How should we treat air leaks?

Cost-Utility Analysis of Biologic and Biosynthetic Mesh in Ventral Hernia Repair: When Are They Worth It? Steven Schneeberger, BS, Sharon Phillips, MSPH,

Daniel A. Barocas, MD, MPH, FACS, Chirag S. Kulahalli, BS, Jesse M

Maureen V. Hill, MD, Ryland S. Stucke, MD, Sarah E

Drivers of readmissions in vascular surgery patients

Taking Control of Your Surgery: Impact of a Prehabilitation Program on Major Abdominal Surgery Ryan Howard, MD, Yue S. Yin, BS, Lane McCandless, BS,

Generation of an Actionable, Preoperative Risk Prediction and Cost Model for Incisional Hernia Using Longitudinal Multi-Hospital Health Data John P.

The National Surgical Quality Improvement Program risk calculator does not adequately stratify risk for patients with clinical stage I non–small cell.

Complications of Pediatric Cholecystectomy: Impact from Hospital Experience and Use of Cholangiography Lorraine I. Kelley-Quon, MD, MSHS, Adrian Dokey,

Changing Surgical Trends in Young Patients with Early Stage Breast Cancer, 2003 to 2010: A Report from the National Cancer Data Base Catherine E. Pesce,

Nader N. Massarweh, MD, MPH, David R. Flum, MD, MPH, FACS, Rebecca G

In type A aortic dissection repair, an effective team approach and relational coordination are more important for patients' outcomes than surgeon volume

Risk factors and indications for readmission after lower extremity amputation in the American College of Surgeons National Surgical Quality Improvement.

Laura A. Graham, PhD, MPH, Todd H. Wagner, PhD, Joshua S

Outcomes in the Management of Appendicitis and Cholecystitis in the Setting of a New Acute Care Surgery Service Model: Impact on Timing and Cost Robert.

Clinically Competent and Fiscally at Risk: Impact of Debt and Financial Parameters on the Surgical Resident Sarah E. Tevis, MD, Andrew P. Rogers, MD,

Standardization of Care: Impact of an Enhanced Recovery Protocol on Length of Stay, Complications, and Direct Costs after Colorectal Surgery Robert H.

Thomas J. Birdas, MD, MBA, FACS, Grace F

Trend in Volume of Urologic Prosthetic Surgery after Initiation of Prostate Cancer Survivorship Program Alison M. Rasper, MD, Kara E. McAbee, MD, Marc.

A New Composite Measure for Assessing Surgical Performance

Military surgeons just want to have fun

Exploring the Relationship Between Stereotype Perception and Residents' Well-Being Arghavan Salles, MD, PhD, Claudia M. Mueller, PhD, MD, FACS, Geoffrey.

Significant Variation in Surgical Supply Cost Secondary to Surgeon Preference for Laparoscopic Cholecystectomy Michelle C. Nguyen, MD, Matthew J. Luzum,

Timing of Complications and Length of Stay after Rectal Cancer Surgery

Rebecca L. Hoffman, MD, Rachel R. Kelz, MD, FACS, Christopher J

Angela M. Ingraham, MD, Mark E. Cohen, PhD, Mehul V

High Risk of Catastrophic Health Expenditure among Uninsured Emergency Surgery Patients in the United States John W. Scott, MD, MPH, Joaquim M. Havens,

Comparison of Hospital Performance in Emergency Versus Elective General Surgery Operations at 198 Hospitals Angela M. Ingraham, MD, Mark E. Cohen, PhD,

Who is your plastic surgeon

Joel T. Adler, MD, MPH, Heidi Yeh, MD, James F

Journal of the American College of Surgeons

Blake Cady, MD, Thomas Miner, MD, Abraham Morgentaler, MD

Syndecan-1: A Quantitative Marker for the Endotheliopathy of Trauma

Trauma: Still the Cornerstone of Acute Care Surgery Specialty

Defining palliative surgery in patients receiving noncurative resections for gastric cancer1 Thomas J Miner, MD, David P Jaques, MD, Martin S Karpeh,

Sashank Reddy, MD, PhD, Georgia C. Yalanis, Russell A

Impact of Resident Involvement in Surgery (IRIS-NSQIP): Looking at the Bigger Picture Based on the American College of Surgeons-NSQIP Database Antoine.

Evidence-Based Bundled Quality Improvement Intervention for Reducing Surgical Site Infection in Lower Extremity Vascular Bypass Procedures Katherine.

Ruchi Thanawala, MD, Jonathan L. Jesneck, PhD, Gladys L

Presentation transcript:

Timed Stair Climbing Is the Single Strongest Predictor of Perioperative Complications in Patients Undergoing Abdominal Surgery Sushanth Reddy, MD, FACS, Carlo M. Contreras, MD, FACS, Brandon Singletary, MPH, T. Miller Bradford, Mary G. Waldrop, Andrew H. Mims, W. Andrew Smedley, Jacob A. Swords, Thomas N. Wang, MD, PhD, FACS, Martin J. Heslin, MD, MSHA, FACS Journal of the American College of Surgeons Volume 222, Issue 4, Pages 559-566 (April 2016) DOI: 10.1016/j.jamcollsurg.2016.01.010 Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 1 Stair climbing and changes in vital signs (VS). Changes in patients' heart rate (HR) and mean arterial pressure (MAP) were calculated as a function of the stair climbing time. Patients who were slower climbing stairs had a greater deviation in their vital signs (Wilcoxon rank sum test, p < 0.0001). Journal of the American College of Surgeons 2016 222, 559-566DOI: (10.1016/j.jamcollsurg.2016.01.010) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 2 Stair climbing time and surgical complications. Patients who were slower to climb stairs had an increased complication rate (Wilcoxon rank sum test, p < 0.0001). Journal of the American College of Surgeons 2016 222, 559-566DOI: (10.1016/j.jamcollsurg.2016.01.010) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 3 Receiver operator characteristic (ROC) curves. The area under the curve is compared with the null hypothesis (diagonal line) where the area is 0.5. The stair climbing time is in blue and the American College of Surgeons (ACS) NSQIP curve is in red. For the stair climbing time and the ACS NSQIP calculator, the area under the curve is 0.8066 (95% CI, 0.75508–0.85806) and 0.6185 (95% CI, 0.54840–0.68863), respectively. The difference in the curves is statistically significant (p < 0.0001). Journal of the American College of Surgeons 2016 222, 559-566DOI: (10.1016/j.jamcollsurg.2016.01.010) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 4 Stair climbing and hospital length of stay. The deviation from predicted length of stay was calculated by subtracting the predicted length of stay from the actual length of stay. Patients who were slower climbing stairs had a relative increase length of stay (Wilcoxon rank sum test, p = 0.033). Journal of the American College of Surgeons 2016 222, 559-566DOI: (10.1016/j.jamcollsurg.2016.01.010) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 5 Stair climbing time and complications for colorectal surgery patients. Slower patients had an increased complication rate (Wilcoxon rank sum test, p < 0.0001). Journal of the American College of Surgeons 2016 222, 559-566DOI: (10.1016/j.jamcollsurg.2016.01.010) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 6 Stair climbing and length of stay for colorectal surgery patients. A stepwise trend is observed as patients with increased stair climbing time had a greater deviation from their expected length of stay, but this did not reach statistical significance (p = 0.36). Journal of the American College of Surgeons 2016 222, 559-566DOI: (10.1016/j.jamcollsurg.2016.01.010) Copyright © 2016 American College of Surgeons Terms and Conditions

Figure 7 Receiver operator characteristic (ROC) curves for colorectal surgery patients. The stair climbing time is in blue and the American College of Surgeons (ACS) NSQIP curve is in red. For the stair climbing time and the ACS NSQIP calculator the area under the curve is 0.7946 (95% CI, 0.64693–0.94236) and 0.5105 (95% CI, 0.32074–0.70027), respectively. The difference in the curves is statistically significant (p = 0.006). Journal of the American College of Surgeons 2016 222, 559-566DOI: (10.1016/j.jamcollsurg.2016.01.010) Copyright © 2016 American College of Surgeons Terms and Conditions