Use of Telemedicine at an Advanced Hernia and Abdominal Wall Reconstruction Program

Abstract

calculate probabilities of 12 postoperative adverse events for all patients in the database. Two statistical methods (Hosmer Lemeshow graphs of deciles of risk and maximum Youden index) were compared in an attempt to define "high risk." RESULTS: Hosmer-Lemeshow plots suggested that a meaningful definition of the "high risk" patient was the 10 th decile of risk. Maximum Youden index found lower risk cutoff points for defining "high risk" patients (close to the overall event rates) and included more patients with events. This resulted in many more patients classified as "high risk" and higher number of patients needed to be treated (NNT) to prevent one complication. Some specialties (thoracic, vascular, general) had relatively high proportions of "high risk" patients, while others (otolaryngology, plastic) had much lower proportions.CONCLUSION: SURPAS could be used to define a "high risk" surgical population that may benefit from risk-mitigating interventions. A cutoff at the 10 th decile approach is preferable as it results in a greater cutoff value and lower numbers needed to treat.