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Does Adding a Measure of Social Vulnerability to a Surgical Risk Calculator Improve Its Performance?
Dyas, Adam R; Carmichael, Heather; Bronsert, Michael R; Henderson, William G; Madsen, Helen J; Colborn, Kathryn L; Velopulos, Catherine G; Meguid, Robert A.
Afiliação
  • Dyas AR; From the Surgical Outcomes and Applied Research Program, Department of Surgery, (Dyas, Carmichael, Bronsert, Henderson, Madsen, Colborn, Velopulos, Meguid), University of Colorado School of Medicine, Aurora, CO.
  • Carmichael H; From the Surgical Outcomes and Applied Research Program, Department of Surgery, (Dyas, Carmichael, Bronsert, Henderson, Madsen, Colborn, Velopulos, Meguid), University of Colorado School of Medicine, Aurora, CO.
  • Bronsert MR; From the Surgical Outcomes and Applied Research Program, Department of Surgery, (Dyas, Carmichael, Bronsert, Henderson, Madsen, Colborn, Velopulos, Meguid), University of Colorado School of Medicine, Aurora, CO.
  • Henderson WG; Adult and Child Center for Health Outcomes Research and Delivery Science (Bronsert, Henderson, Meguid), University of Colorado School of Medicine, Aurora, CO.
  • Madsen HJ; From the Surgical Outcomes and Applied Research Program, Department of Surgery, (Dyas, Carmichael, Bronsert, Henderson, Madsen, Colborn, Velopulos, Meguid), University of Colorado School of Medicine, Aurora, CO.
  • Colborn KL; Adult and Child Center for Health Outcomes Research and Delivery Science (Bronsert, Henderson, Meguid), University of Colorado School of Medicine, Aurora, CO.
  • Velopulos CG; the Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO (Henderson, Colborn).
  • Meguid RA; From the Surgical Outcomes and Applied Research Program, Department of Surgery, (Dyas, Carmichael, Bronsert, Henderson, Madsen, Colborn, Velopulos, Meguid), University of Colorado School of Medicine, Aurora, CO.
J Am Coll Surg ; 234(6): 1137-1146, 2022 06 01.
Article em En | MEDLINE | ID: mdl-35703812
BACKGROUND: Emerging literature suggests that measures of social vulnerability should be incorporated into surgical risk calculators. The Social Vulnerability Index (SVI) is a measure designed by the CDC that encompasses 15 socioeconomic and demographic variables at the census tract level. We examined whether adding the SVI into a parsimonious surgical risk calculator would improve model performance. STUDY DESIGN: The eight-variable Surgical Risk Preoperative Assessment System (SURPAS), developed using the entire American College of Surgeons (ACS) NSQIP database, was applied to local ACS-NSQIP data from 2012 to 2018 to predict 12 postoperative outcomes. Patient addresses were geocoded and used to estimate the SVI, which was then added to the model as a ninth predictor variable. Brier scores and c-indices were compared for the models with and without the SVI. RESULTS: The analysis included 31,222 patients from five hospitals. Brier scores were identical for eight outcomes and improved by only one to two points in the fourth decimal place for four outcomes with addition of the SVI. Similarly, c-indices were not significantly different (p values ranged from 0.15 to 0.96). Of note, the SVI was associated with most of the eight SURPAS predictor variables, suggesting that SURPAS may already indirectly capture this important risk factor. CONCLUSION: The eight-variable SURPAS prediction model was not significantly improved by adding the SVI, showing that this parsimonious tool functions well without including a measure of social vulnerability.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Vulnerabilidade Social Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Am Coll Surg Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2022 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Vulnerabilidade Social Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Am Coll Surg Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2022 Tipo de documento: Article País de publicação: Estados Unidos