ObjectiveThe National Surgical Quality Improvement Program (NSQIP) calculator was
created to improve outcomes and guide cost-effective care in surgery.
Patients with head and neck cancer (HNC) undergo ablative and free flap
reconstructive surgery with prolonged postoperative courses.MethodsA case series with chart review was performed on 50 consecutive patients with
HNC undergoing ablative and reconstructive free flap surgery from October
2014 to March 2016 at a tertiary care center. Comorbidities and
intraoperative and postoperative variables were collected. Predicted length
of stay was tabulated with the NSQIP calculator.ResultsThirty-five patients (70%) were male. The mean (SD) age was 67.2 (13.4)
years. The mean (SD) length of stay (LOS) was 13.5 (10.3) days. The mean
(SD) NSQIP-predicted LOS was 10.3 (2.2) days (P =
.027).DiscussionThe NSQIP calculator may be an inadequate predictor for LOS in patients with
HNC undergoing free flap surgery. Additional study is necessary to determine
the accuracy of this tool in this patient population.Implications for Practice:Head and neck surgeons performing free flap reconstructive surgery following
tumor ablation may find that the NSQIP risk calculator underestimates the
LOS in this population.
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