Does the ACS NSQIP Surgical Risk Calculator Accurately Predict Complications Rates After Anterior Lumbar Interbody Fusion Procedures?

Ankur S. Narain, MD; Alexander Z. Kitto, MD; Benjamin Braun, MD; Matthew J. Poorman, MD; Patrick Curtin, MD; Justin Slavin, MD; Giles Whalen, MD; Christian P. DiPaola, MD; Patrick J. Connolly, MD; Michael P. Stauff, MD


Spine. 2021;46(12):E655-E662. 

In This Article


The ACS NSQIP surgical risk calculator is an adequate prediction tool for a subset of complications after ALIF including acute renal failure/progressive renal insufficiency, surgical site infections, and discharge to non-home facility. However, the ACS NSQIP surgical risk calculator is a poor predictor for all other complication groups that were analyzed. The reliability and applicability of the ACS NSQIP surgical risk calculator for ALIF procedures is limited. Many possible reasons exist for these limitations, including inadequate representation of both patient risk-factors and procedure complexity within the calculator's parameters. Further specialty-specific and procedure-specific risk stratification tools are required and their development represents a potential future direction for research.