Customize your JAMA Network experience by selecting one or more topics from the list below.
Liu JB, Weber SM, Berian JR, et al. Role of Operative Complexity Variables in Risk Adjustment for Patients With Cancer. JAMA Surg. 2016;151(11):1084–1086. doi:https://doi.org/10.1001/jamasurg.2016.2253
The comprehensive capture of relevant details of patients is essential to accurately predict outcomes and benchmark hospital performance.1 Members of the Oncology NSQIP National Cancer Center Collaborative (ONNCC), established in 2011, were concerned that important oncology-related variables were not captured by the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). The ONNCC began collecting 3 additional case characteristics representing greater operative complexity and risk with the aim to improve patient risk prediction and case-mix adjustment.2
Trained surgical clinical reviewers from 16 ONNCC hospitals abstracted 3 novel variables not routinely collected in ACS NSQIP (“Previous Surgery in the Operative Region,” “Previous Radiotherapy to the Operative Region,” and “Previous Chemotherapy”). All variables were stratified by time from surgery (≥90 days vs <90 days). For example, consider a patient with a distant history of prostatectomy and adjuvant pelvic radiotherapy now undergoing low anterior resection for rectal cancer. The operative region (the pelvis) will be reentered; thus, the data coded for this patient is “Previous Surgery: ≥90 days,” “Previous Radiotherapy: ≥90 days,” and “Previous Chemotherapy: None.”
Create a personal account or sign in to: