ACS NSQIP Surgical Risk Calculator accurately estimates complication risks

Editor's Note

This study finds that the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Surgical Risk Calculator serves its intended purpose of providing a general purpose risk calculator, which is applicable across many surgical domains, using easily understood and generally available predictive information.

The Surgical Risk Calculator's predictive failures, reported by recent studies, were a result of design limitations of those studies and should not be misunderstood as disqualifying the calculator as an a accurate and appropriate tool, the authors say.

The American College of Surgeons NSQIP offers a Surgical Risk Calculator (SRC) that provides detailed, patient-level, risk assessments for many adverse outcomes to surgeons, patients, and the general public. The SRC calculator was designed to help guide discussion and decisions by providing generally applicable (not hospital-specific) information about surgical risk using easily understood and broadly available preoperative variables. Although large, internal evaluations have shown that the SRC has good accuracy (model discrimination and calibration), external validations have been inconsistent and tend to favor a conclusion of inadequate performance.