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Research Letter
Pacific Coast Surgical Association
August 2015

Comparing the National Surgical Quality Improvement Program With the Nationwide Inpatient Sample Database

Author Affiliations
  • 1Department of Surgery, University of California, San Diego
  • 2Department of Surgery, University of California, Davis, Sacramento
  • 3Department of Surgery, Massachusetts General Hospital, Boston
JAMA Surg. 2015;150(8):815-816. doi:10.1001/jamasurg.2015.0962

Both raw and risk-adjusted outcomes are increasingly being made publicly available.1-3 The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) is heralded as the most robust database to examine surgical outcomes. However, enrollment in the NSQIP is expensive, and the use of administrative databases may be more cost-effective.2-4

In our study, we compare the receiver operating characteristic curves of the Nationwide Inpatient Sample (NIS) with those of the NSQIP to determine which is superior at performing analyses of risk-adjusted outcomes for several operations.

Our study uses 2010 data from both the NIS and the NSQIP. Inpatients older than 18 years of age were included. Patients were identified by International Classification of Diseases, Ninth Revision codes (NIS) and Current Procedural Terminology codes (NSQIP): abdominal aortic aneurysm repair, appendectomy, aortic valve replacement, coronary artery bypass graft, carotid endarterectomy, laparoscopic cholecystectomy, total and partial colectomy, esophagectomy, sleeve gastrectomy, pancreatectomy, and ventral hernia repair. Outcomes included inpatient death and complications. Patients were classified as having a complication if they had one of the following: infection (surgical site, deep incisional, and organ/space), wound disruption, pneumonia, pulmonary embolism, acute renal failure, urinary tract infection, cerebrovascular accident, myocardial infarction, and blood loss requiring transfusion.