ACS NSQIP Risk Calculator

Prasad, Kumar G.; Nelson, Benton G.; Deig, Christopher R.; Schneider, Alexander L.; Moore, Michael G.

doi:10.1177/0194599816655976

Cited by 62 publications

(25 citation statements)

References 5 publications

(14 reference statements)

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“…20 Prasad et al reviewed 98 patients who underwent major head and neck surgery, not specific to free flap, and they also demonstrated that the SRC had poor predictive value in predicting individual risk of postoperative complications. 23 Our work represents the largest cohort study to examine all outcomes of the SRC, including complications, LOS, and rehabilitation discharge in a variety of free flap reconstructions.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of the NSQIP Surgical Risk Calculator in Predicting Microvascular Head and Neck Reconstruction Outcomes

Laitman

Patel

et al. 2018

Otolaryngol.--head neck surg.

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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.

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Section: Discussionmentioning

confidence: 99%

“…A threshold of 0.01 was used for good calculator performance, as in previous studies of the SRC. 22,23 Calculated Brier scores were scaled for prevalence of the postoperative outcome in our population. The SRC's ability to discriminate between patients with and without corresponding complications was described with the ROC AUC.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the NSQIP Surgical Risk Calculator in Predicting Microvascular Head and Neck Reconstruction Outcomes

Laitman

Patel

et al. 2018

Otolaryngol.--head neck surg.

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“…Another study conducted to validate the use of ACSNSQIP risk prediction in head and neck cancer was published by Prasad et al [3], who found that the score did little to predict an individual patient's risk of complications but overall predicted a similar number of complications. In our study, however, a patient's individual risk and the overall incidence of complications in the cohort were both inaccurate.…”

Section: Discussionmentioning

confidence: 99%

“…The ACSNSQIP calculator has been designed for use across multiple surgical disciplines, with specific Current Procedural Terminology (CPT) codes for a variety of surgeries. External validation for head and neck surgery has been limited, with only a few studies available in published literature [3,4], neither of which found the calculator reliable.…”

Section: Introductionmentioning

confidence: 99%

ACSNSQIP Risk Calculator in Indian Patients Undergoing Surgery for Head and Neck Cancers: Is It Valid?

Subramaniam

Balasubramanian

Rka

et al. 2018

Indian J Surg Oncol

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Pre-operative assessment is vital to determine patient-specific risks and minimize them in order to optimize surgical outcomes. The American College of Surgeons National Surgical Quality Improvement Program (ACSNSQIP) Surgical Risk Calculator is the most comprehensive surgical risk assessment tool available. We performed this study to determine the validity of ACSNSQIP calculator when used to predict surgical complications in a cohort of patients with head and neck cancer treated in an Indian tertiary care center. Retrospective data was collected for 150 patients with head and neck cancer who were operated in the Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Kochi, in the year 2016. The predicted outcome data was compared with actual documented outcome data for the variables mentioned. Brier's score was used to estimate the predictive value of the risk assessment generated. Pearson's coefficient was utilized to validate the prediction of length of hospital stay. Brier's score for the entire calculator was 0.32 (not significant). Additionally, when the score was determined for individual parameters (surgical site infection, pneumonia, etc.), none were significant. Pearson's value for length of stay was also not significant ( = .632). The ACSNSQIP risk assessment tool did not accurately reflect surgical outcomes in our cohort of Indian patients. Although it is the most comprehensive tool available at present, modifications that may improve accuracy are allowing for input of multiple procedure codes, risk stratifying for previous radiation or surgery, and better risk assessment for microvascular flap reconstruction.

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“…We selected the “1 = no adjustment necessary” label, which has been used in several publications across surgical specialties. 15 , 30 , 31 Further research is required to determine which surgeon-selected adjustment is best suited for this particular patient population.…”

Section: Discussionmentioning

confidence: 99%

NSQIP as a Predictor of Length of Stay in Patients Undergoing Free Flap Reconstruction

et al. 2017

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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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ACS NSQIP Risk Calculator

Cited by 62 publications

References 5 publications

Assessment of the NSQIP Surgical Risk Calculator in Predicting Microvascular Head and Neck Reconstruction Outcomes

Assessment of the NSQIP Surgical Risk Calculator in Predicting Microvascular Head and Neck Reconstruction Outcomes

ACSNSQIP Risk Calculator in Indian Patients Undergoing Surgery for Head and Neck Cancers: Is It Valid?

NSQIP as a Predictor of Length of Stay in Patients Undergoing Free Flap Reconstruction

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