CL-16: VALIDATION OF THE ACS RISK CALCULATOR IN A SURGICAL PALLIATIVE CARE COHORT
Allen Zhong, MD, Kathryn Chuquin, MD, Celia Divino, MD; Mount Sinai Hospital
Background: Goals of care (GOC) discussions are an essential component of surgical care. A surgical advanced care note incorporating the American College of Surgeons Surgical Risk Calculator was created and implemented to facilitate and train surgical residents in these discussions. A validation study of the risk calculator was then performed.
Methods: A cohort of 75 patients who had a surgical advanced care notes written for them in a 10-month period was retrospectively analyzed. The predicted risk of surgical complications was then calculated using the ACS risk calculator for every patient. The cohortâs average risk for every complication was then compared to the overall corresponding complication rate in the cohort
Results: Complications that were accurately predicted in our cohort included rates of pneumonia (predicted 5.17% vs. actual 6.45%, p- 0.77), VTE (2.74 vs. 3.23, p- 0.9), readmission (12.7 vs. 12.9, p- 0.84), renal failure (2.39 vs. 1.64, p- 0.54), LOS (8.4 vs. 10.53, p- 0.99), and death (12.51 vs. 15.94, p- 0.5).
Conclusions: The ACS risk calculator was validated in this cohort. Incorporation of the ACS risk calculator into our advanced care note is an important quantitative tool to our surgical providers when navigating and facilitating goals of care discussion.