Validity of the assessment of postoperative complications of femoral head replacement in elderly patients / 中华老年医学杂志

ABSTRACT

Objective To evaluate the effectiveness of American College of Surgeons (ACS) National Surgical Quality Improvement Program(NSQIP)surgical risk calculator in the evaluation of postoperative complications of elderly patients undergoing prosthetic femoral head replacement.Methods Three hundred and forty five elderly patients(＞60 years)who had underdone femoral head replacement from January 2013 to December 2015 were recruited.Data on twenty-one parameters(age,sex,functional status,etc.)were collected for the ACS NSQIP surgical risk calculator and predictive values for complications were also obtained.The ROC curve was compared with the actual complication.The Pearson correlation coefficient was used to analyze the correlation between serious complications and the 21 parameters,and the correlation between different complications.Results There were 12 complications,including death,urinary tract infection,venous thrombosis,cardiovascular events,renal failure,pneumonia,surgical site infection,any complication,serious complications,readmission,return to OR,and discharge to nursing or rehab facilities.The ACS NSQIP surgical risk assessment calculator was able to predict postoperative complications(AUC＞0.5,except surgical site infection,for which AUC=0.47).The predictive value for discharge to nursing or rehab facilities was the highest(AUC=0.62).Moreover,there was a significant correlation between complications and the 21 parameters(P＜0.05).Cardiovascular events were significantly associated with the occurrence of pneumonia in common complications (Person correlation coefficient0.91,95 ％ CI0.86 ～ 0.94,P ＜0.05).Conclusions The ACS NSQIP calculator is effective in predicting postoperative complications inelder patients with prosthetic femoral head replacement.