The Role of ACS NSQIP in Orthopaedic Surgery Practice, Research, and Quality Evaluation

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) is a multicenter variable-based data registry that facilitates surgical quality tracking, hospital benchmarking, and outcome predictions. ACS NSQIP data within Orthopaedic Surgery consist primarily of the 30 most common orthopaedic procedures and collect demographic and 30-day complication metrics for inpatient and outpatient procedures. Although the original intent of this large database was quality improvement, it has also been used extensively in orthopaedic research since 2010 to evaluate risk factors in orthopaedic surgery, despite systematic reviews demonstrating weaknesses in reproducibility and impact. Comparisons of ACS NSQIP to orthopaedic surgery-specific databases demonstrate a shortcoming of NSQIP in identifying patients, prevalence of complications, and tracking complications. Although ACS NSQIP provides a chance for large-scale data analysis in quality tracking and research, its reliability and usefulness in orthopaedic surgery remain to be established.