TY - JOUR
T1 - Assessment of the NSQIP Surgical Risk Calculator in Predicting Microvascular Head and Neck Reconstruction Outcomes
AU - Ma, Yue
AU - Laitman, Benjamin M.
AU - Patel, Vir
AU - Teng, Marita
AU - Genden, Eric
AU - DeMaria, Samuel
AU - Miles, Brett A.
N1 - Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2018.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objective: This study evaluated the accuracy of the Surgical Risk Calculator (SRC) of the ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Program) in predicting head and neck microvascular reconstruction outcomes. Study Design: Retrospective analysis. Setting: Tertiary medical center. Subjects and Methods: A total of 561 free flaps were included in the analysis. The SRC-predicted 30-day rates of postoperative complications, hospital length of stay (LOS), and rehabilitation discharge were compared with the actual rates and events. The SRC’s predictive value was examined with Brier scores and receiver operating characteristic area under the curve. Results: A total of 425 myocutaneous, 134 osseous (84 fibula, 47 scapula, and 3 iliac crest), and 2 omental free flaps were included in this study. All perioperative complications evaluated had area under the curve values ≤0.75, ranging from 0.480 to 0.728. All but 2 postoperative complications had Brier scores >0.01. SRC-predicted LOS was 9.4 ± 2.38 days (mean ± SD), which did not strongly correlate with the actual LOS of 11.98 ± 9.30 days (r = 0.174, P <.0001). Conclusion: The SRC is a poor predictor for surgical outcome among patients undergoing microvascular head and neck reconstruction.
AB - Objective: This study evaluated the accuracy of the Surgical Risk Calculator (SRC) of the ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Program) in predicting head and neck microvascular reconstruction outcomes. Study Design: Retrospective analysis. Setting: Tertiary medical center. Subjects and Methods: A total of 561 free flaps were included in the analysis. The SRC-predicted 30-day rates of postoperative complications, hospital length of stay (LOS), and rehabilitation discharge were compared with the actual rates and events. The SRC’s predictive value was examined with Brier scores and receiver operating characteristic area under the curve. Results: A total of 425 myocutaneous, 134 osseous (84 fibula, 47 scapula, and 3 iliac crest), and 2 omental free flaps were included in this study. All perioperative complications evaluated had area under the curve values ≤0.75, ranging from 0.480 to 0.728. All but 2 postoperative complications had Brier scores >0.01. SRC-predicted LOS was 9.4 ± 2.38 days (mean ± SD), which did not strongly correlate with the actual LOS of 11.98 ± 9.30 days (r = 0.174, P <.0001). Conclusion: The SRC is a poor predictor for surgical outcome among patients undergoing microvascular head and neck reconstruction.
KW - NSQIP
KW - free flap
KW - free tissue transfer
KW - surgical risk calculator
UR - http://www.scopus.com/inward/record.url?scp=85050909284&partnerID=8YFLogxK
U2 - 10.1177/0194599818789132
DO - 10.1177/0194599818789132
M3 - Article
C2 - 30040536
AN - SCOPUS:85050909284
SN - 0194-5998
VL - 160
SP - 100
EP - 106
JO - Otolaryngology - Head and Neck Surgery
JF - Otolaryngology - Head and Neck Surgery
IS - 1
ER -