Finding a Tool to Assess Risk of Complications from THA and TKA

    Can the online surgical risk calculator from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) be used to predict 30-day complication rates in Medicare patients who have undergone total hip and total knee arthroplasty?

    To find out, researchers from Northwestern University in Chicago applied the ACS-NSQIP risk calculator to their own publicly reported 30-day outcomes data from July to December 2009.

    The results were not promising: They found this risk calculator to be a poor predictor of the 30-day risk of complications from total hip and total knee arthroplasty, such as venous thromboembolism, urinary tract infection, need for reoperation, and death, indicating it is not an appropriate risk assessment tool for these procedures.

    Why is this important? The study authors note that quality of care is already linked to reimbursement for surgeons and hospitals by the Centers for Medicare and Medicaid Services, and they believe “accurate risk stratification of patients undergoing total hip and knee arthroplasty … [will] likely soon be mandated … in the highly scrutinized world of pay-for-performance, value-driven healthcare.”

    We asked Linda I. Suleiman, MD, one of the study authors, to elaborate on the data reported in their study, which was presented at the recent annual meeting of the Mid-America Orthopaedic Association.

    Click the image above to hear her comments.

    Producer and Director: Michael Bugera; Post Production: Charles Maynard


    Edelstein AI, Suleiman LI, Khakhkhar R, Moore M, Kwansy MM, Beal MD, Manning DM. Can the American College of Surgeons Risk Calculator Predict Outcomes After Hip and Knee Arthroplasty? (Paper 204). Presented at the Mid-America Orthopaedic Association Annual Meeting, April 22-25, 2015, Hilton Head Island, South Carolina.