Table 1.
Demographic characteristics, Risk Analysis Index (RAI) components and mortality (30-, 180- and 365-day) for the recalibration cohort (development and confirmation samples) using VASQIP) data [2010–2014]; and the external validation cohort using ACS-NSQIP data [2005–2014] and NWIHCS VA data [prospective RAI-C validation].
| VASQIP | ACS-NSQIP | NWIHCS | |||
|---|---|---|---|---|---|
| Recalibration Development Sample | Recalibration Confirmation Sample | External validation Sample | RAI-C validation sample | ||
| N=322,152 | N=158,579 | N=1,391,785 | N=6856 | ||
| Variable | Category | N (%) | N (%) | N (%) | N (%) |
| Gender | Female | 25,159 (7.8) | 12,420 (7.8) | 807,087 (58.0) | 249 (3.6) |
| Male | 296,993 (92.2) | 146,159 (92.2) | 584,698 (42.0) | 6,607 (96.4) | |
| Age at Time of RAI (yrs.) | < 20 | 101 (0.0) | 56 (0.0) | 17,369 (1.3) | 1 (0.0) |
| 20–24 | 2,086 (0.7) | 1,067 (0.7) | 28,802 (2.1) | 64 (0.9) | |
| 25–29 | 7,012 (2.2) | 3,396 (2.1) | 47,097 (3.4) | 193 (2.8) | |
| 30–34 | 7,858 (2.4) | 3,811 (2.4) | 61,612 (4.4) | 197 (2.9) | |
| 35–39 | 7,737 (2.4) | 3,760 (2.4) | 80,860 (5.8) | 186 (2.7) | |
| 40–44 | 12,285 (3.8) | 6,015 (3.8) | 105,259 (7.6) | 256 (3.7) | |
| 45–49 | 17,305 (5.4) | 8,613 (5.4) | 131,351 (9.4) | 354 (5.2) | |
| 50–54 | 28,834 (9.0) | 14,316 (9.0) | 149,172 (10.7) | 570 (8.3) | |
| 55–59 | 40,738 (12.7) | 20,288 (12.8) | 153,204 (11.0) | 712 (10.4) | |
| 60–64 | 75,598 (23.5) | 36,971 (23.3) | 153,597 (11.0) | 1,458 (21.3) | |
| 65–69 | 55,852 (17.3) | 27,163 (17.1) | 142,281 (10.2) | 1,299 (19.0) | |
| 70–74 | 24,845 (7.7) | 12,377 (7.8) | 115,397 (8.3) | 601 (8.8) | |
| 75–79 | 19,738 (6.1) | 9,749 (6.2) | 94,480 (6.8) | 443 (6.5) | |
| 80–84 | 13,153 (4.1) | 6,474 (4.1) | 66,581 (4.8) | 332 (4.8) | |
| 85–89 | 7,040 (2.2) | 3,530 (2.2) | 33,460 (2.4) | 157 (2.3) | |
| ≥ 90 | 1,970 (0.6) | 993 (0.6) | 11,263 (0.8) | 33 (0.5) | |
| Mean (SD) | 60.7 (13.1) | 60.7 (13.1) | 56.3 (16.6) | 60.7 (13.9) | |
| Race | White | 222,722 (69.1) | 109,535 (69.1) | 912,117 (75.6) | 2,224 (32.4) |
| Black | 48,906 (15.2) | 24,154 (15.2) | 119,002 (9.9) | 128 (1.9) | |
| Other | 3,586 (1.1) | 1,725 (1.1) | 35,503 (2.9) | 4,189 (61.1) | |
| Unknown | 46,938 (14.6) | 23,165 (14.6) | 140,381 (11.6) | 315 (4.6) | |
| Ethnicity | Not Hispanic or Latino | 281,930 (87.5) | 139,125 (87.7) | 1,060,916 (76.2) | 6,509 (94.9) |
| Hispanic or Latino | 17,119 (5.3) | 8,187 (5.2) | 77,516 (5.6) | 32 (0.5) | |
| Unknown | 23,023 (7.2) | 11,267 (7.1) | 253,353 (18.2) | 315 (4.6) | |
| BMI 1 | < 18.5 | 5,906 (1.8) | 3,015 (1.9) | 20720 (1.5) | 6 (0.1) |
| ≥ 18.5 & < 25 | 78,434 (24.4) | 38,182 (24.1) | 317,026 (22.8) | 103 (1.5) | |
| ≥ 25 & < 30 | 113,635 (35.3) | 55,976 (35.3) | 420,945 (30.2) | 200 (2.9) | |
| ≥ 30 & < 35 | 77,621 (24.1) | 38,380 (24.2) | 281,999 (20.3) | 152 (2.2) | |
| ≥ 35 & < 40 | 31,542 (9.8) | 15,560 (9.8) | 150,839 (10.8) | 91 (1.3) | |
| ≥ 40 | 13,675 (4.2) | 6,758 (4.3) | 177,213 (12.7) | 28 (0.6) | |
| Unknown | 1,339 (0.4) | 709 (0.4) | 23,043 (1.7) | 6,266 (91.4) | |
| Mean (SD) | 28.9 (5.9) | 28.9 (5.9) | 30.8 (8.4) | 30.3 (6.3) | |
| Cancer # | 6,341 (2.0) | 3,175 (2.0) | 26,773 (1.9) | 1,197 (17.5) | |
| Unintentional weight loss | 8,180 (2.5) | 4,057 (2.6) | 26,391 (1.9) | 273 (4.0) | |
| Poor Appetite | NA | NA | NA | 312 (4.6) | |
| Renal Failure | 1,461 (0.5) | 777 (0.5) | 26,412 (1.9) | 239 (3.5) | |
| Congestive Heart Failure | 2,189 (0.7) | 1,103 (0.7) | 10,297 (0.7) | 274 (4.0) | |
| Dyspnea | 3,421 (1.1) | 1,682 (1.1) | 12,610 (0.9) | 433 (3.3) | |
| Other Living Setting | 4,724 (1.5) | 2,314 (1.5) | 32,713 (2.4) | 157 (2.3) | |
| Cognitive Decline | 11,343 (3.5) | 5,571 (3.5) | 33,443 (2.4) | 93 (1.4) | |
| Functional Status | Independent | 298,590 (92.7) | 146,959 (92.7) | 1,329,567 (95.5) | NA |
| Partially Dependent | 18,320 (5.7) | 8,990 (5.7) | 49,919 (3.6) | NA | |
| Totally Dependent | 5,242 (1.6) | 2,630 (1.7) | 12,299 (0.9) | NA | |
| Activities of Daily Living: Mobility/Loco motion | 0:Independent | NA | NA | NA | 6,692 (97.6) |
| 1: Supervised | NA | NA | NA | 35 (0.5) | |
| 2: Limited Assist | NA | NA | NA | 69 (1.0) | |
| 3: Extensive Assist | NA | NA | NA | 32 (0.5) | |
| 4: Total Dependent | NA | NA | NA | 28 (0.4) | |
| Activities of Daily Living: Eating | 0: Independent | NA | NA | NA | 6,778 (98.9) |
| 1: Supervised | NA | NA | NA | 30 (0.4) | |
| 2: Limited Assist | NA | NA | NA | 18 (0.3) | |
| 3: Extensive Assist | NA | NA | NA | 11 (0.2) | |
| 4: Total Dependent | NA | NA | NA | 19 (0.3) | |
| Activities of Daily Living: Toilet Use | 0: Independent | NA | NA | NA | 6,749 (98.4) |
| 1: Supervised | NA | NA | NA | 26 (0.4) | |
| 2: Limited Assist | NA | NA | NA | 32 (0.5) | |
| 3: Extensive Assist | NA | NA | NA | 23 (0.3) | |
| 4: Total Dependent | NA | NA | NA | 26 (0.4) | |
| Activities of Daily Living: Personal Hygiene | 0: Independent | NA | NA | NA | 6,724 (98.1) |
| 1: Supervised | NA | NA | NA | 31 (0.4) | |
| 2: Limited Assist | NA | NA | NA | 50 (0.7) | |
| 3: Extensive Assist | NA | NA | NA | 25 (0.4) | |
| 4: Total Dependent | NA | NA | NA | 26 (0.4) | |
| RAI | 0–4 | 23,410 (7.3) | 11,543 (7.3) | 688,422 (49.5) | 203 (3.0) |
| 5–9 | 244,255 (75.8) | 119,779 (75.5) | 523,123 (37.6) | 4,280 (62.4) | |
| 10–14 | 18,857 (5.9) | 9,582 (6.0) | 83,116 (6.0) | 593 (8.7) | |
| 15–19 | 17,946 (5.6) | 8,871 (5.6) | 44,104 (3.2) | 417 (6.1) | |
| 20–24 | 6,454 (2.0) | 3,191 (2.0) | 25,048 (1.8) | 461 (6.7) | |
| 25–29 | 5,779 (1.8) | 2,868 (1.8) | 16,509 (1.2) | 631 (9.2) | |
| 30–34 | 3,197 (1.0) | 1,662 (1.1) | 6,583 (0.5) | 177 (2.6) | |
| ≥ 35 | 2,254 (0.7) | 1,083 (0.7) | 4,880 (0.4) | 94 (1.4) | |
| Mean (SD) | 8.6 (5.6) | 8.7 (5.6) | 5.9 (5.5) | 11.8 (8.1) | |
| Revised RAI | 0–4 | 2,753 (0.9) | 1,402 (0.9) | 73,594 (5.3) | 80 (1.2) |
| 5–9 | 19,418 (6.0) | 9,432 (6.0) | 127,813 (9.2) | 367 (5.4) | |
| 10–14 | 24,572 (7.6) | 12,108 (7.6) | 289,473 (20.8) | 443 (6.5) | |
| 15–19 | 71,150 (22.1) | 34,951 (22.0) | 315,783 (22.7) | 1,286 (18.8) | |
| 20–24 | 122,687 (38.1) | 59,829 (37.7) | 293,327 (21.1) | 1,993 (29.1) | |
| 25–29 | 46,504 (14.4) | 23,460 (14.8) | 180,474 (13.0) | 1,010 (14.7) | |
| 30–34 | 17,224 (5.4) | 8,637 (5.5) | 61,669 (4.4) | 354 (5.2) | |
| 35–39 | 10,611 (3.3) | 5,159 (3.3) | 31,534 (2.3) | 979 (14.3) | |
| 40–44 | 4,433 (1.4) | 2,203 (1.4) | 11,552 (0.8) | 210 (3.1) | |
| 45–49 | 1,683 (0.5) | 870 (0.6) | 4,633 (0.3) | 96 (1.4) | |
| ≥ 50 | 1,117 (0.4) | 528 (0.3) | 1,933 (0.1) | 38 (0.6) | |
| Mean (SD) | 21.2 (7.5) | 21.2 (7.5) | 18.1 (8.4) | 23.9 (9.4) | |
| 30-day Mortality after Surgery | 3,463 (1.1) | 1,801 (1.1) | 13,408 (1.0) | 29 (0.4) | |
| 180-day Mortality after Surgery | 11,416 (3.5) | 5,835 (3.7) | NA | 114 (1.8) | |
VASQIP: Veterans Affairs Surgical Quality Improvement Program; ACS-NSQIP: American College of Surgeons National Surgical Quality Improvement Program; NWIHCS: Nebraska Western Iowa Health Care System; SD: standard deviation; BMI: body mass index
1
Values below 10 and above 90 were recoded to unknown