Estimation of Risk in Cancer Patients Undergoing Palliative Procedures by the American College of Surgeons Risk Calculator

Abstract

The ACSRC is a powerful tool for aid in surgical decision-making; however, in the case of palliative procedures for cancer patients, it overestimated the risk of postoperative complications and underestimated the LOS. Overestimation of post-operative complications could result in fewer patients being offered potentially beneficial palliative procedures.

Comparison of common risk stratification indices to predict outcomes among stage IV cancer patients with bowel obstruction undergoing surgery

“…Currently, the ACS‐NSQIP surgical risk calculator may serve as a potential resource for this purpose. However, recent research investigating the reliability of the ACS‐NSQIP calculator for palliative surgeries in cancer patients has noted various limitations . For example, Rodriguez et al compared palliative surgery outcomes among cancer patients at a single institution to ACS‐NSQIP surgical risk calculator predicted outcomes and found that the ACS‐NSQIP risk calculator underestimated hospital length of stay and overestimated the risk of complications.…”

“…However, recent research investigating the reliability of the ACS‐NSQIP calculator for palliative surgeries in cancer patients has noted various limitations . For example, Rodriguez et al compared palliative surgery outcomes among cancer patients at a single institution to ACS‐NSQIP surgical risk calculator predicted outcomes and found that the ACS‐NSQIP risk calculator underestimated hospital length of stay and overestimated the risk of complications. As our data and the Rodgriquez analysis demonstrates, DMa patients undergoing palliative surgical procedures consist of a unique patient population, and differences in patient demographics, frailty, and other undefined factors can significantly impact patient risk profiles and the predictive ability of various risk prediction models.…”

Untitled

“…If a surgeon is willing to undertake a challenging procedure, the risk of complications is difficult to estimate; even a powerful tool like The American College of Surgeons Risk Calculator (ACSRC) in surgical decision-making for palliative procedures for cancer patients overestimates the risk of postoperative complications. It may underestimate length of stay [12], thus leading to even fewer patients being offered potentially beneficial palliative procedures.…”