Predictive Value of the ACS-NSQIP Surgical Risk Calculator in Patients Undergoing Transsphenoidal Hypophysectomy

Background: Transsphenoidal hypophysectomy (TSSH) is the preferred treatment approach for pituitary tumors. Given the potential for serious complications, we aimed to assess the utility of the ACS-NSQIP calculator for accurately predicting which patients are at increased risk for complications. We hypothesized that the ACS-NSQIP would accurately predict length of stay (LOS) and hospital readmission and postsurgical complications following TSSH.

Methods: A retrospective chart review of all patients who underwent transsphenoidal hypophysectomy for pituitary tumors at West Virginia University School of Medicine from August 2017 to present was performed.

Results: ACS-NSQIP predicted average LOS at 4.0 days compared with observed 4.9 days LOS (p = 0.2). Of the patients we reviewed, only 5.6% were readmitted to the hospital. For patients who were readmitted, the average predicted risk of readmission was 9.6% compared with 8.5% risk for those who were not actually readmitted. Of the patients with a high predictive rate of complication, 15% had an increased length of stay due to those complications.

Conclusion: No significant difference was found between predicted LOS and observed LOS, indicating that the ACS-NSQIP calculator provides an accurate estimate for hospital LOS. The predicted risk of hospital readmission was lower for the patients who were not actually readmitted, although the data were limited via too few numbers of hospital readmission. Future directions include expanding data collection and evaluating ACS NS-QIP predictive value for serious complications and return to operating room.

No conflict of interest has been declared by the author(s).