Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-23T13:13:19.041Z Has data issue: false hasContentIssue false

Validity of the American College of Surgeons' National Surgical Quality Improvement Program risk calculator in South Australian glossectomy patients

Published online by Cambridge University Press:  19 July 2017

S S Kao*
Affiliation:
ENT Head and Neck Surgery, Flinders Medical Centre, Bedford Park, Adelaide, Australia
C Frauenfelder
Affiliation:
ENT Head and Neck Surgery, Flinders Medical Centre, Bedford Park, Adelaide, Australia
D Wong
Affiliation:
ENT Head and Neck Surgery, Flinders Medical Centre, Bedford Park, Adelaide, Australia
S Edwards
Affiliation:
School of Public Health, University of Adelaide, Adelaide, Australia
S Krishnan
Affiliation:
ENT Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, Australia
E H Ooi
Affiliation:
ENT Head and Neck Surgery, Flinders Medical Centre, Bedford Park, Adelaide, Australia Department of Surgery, Flinders University, Adelaide, Australia
*
Address for correspondence: Dr Stephen Shih-Teng Kao, ENT Head and Neck Surgery, Flinders Medical Centre, Flinders Dr, Bedford Park, SA 5042, Australia E-mail: [email protected]

Abstract

Background:

Appropriate selection of tongue cancer patients considering surgery is critical in ensuring optimal outcomes. The American College of Surgeons' National Surgical Quality Improvement Program (‘ACS-NSQIP’) risk calculator was developed to assess patients' 30-day post-operative risk, providing surgeons with information to guide decision making.

Method:

A retrospective review of 30-day actual mortality and morbidity of tongue cancer patients was undertaken to investigate the validity of this tool for South Australian patients treated from 2005 to 2015.

Results:

One hundred and twenty patients had undergone glossectomy. Predicted length of stay using the risk calculator was significantly different from actual length of stay. Predicted mortality and other complications were found to be similar to actual outcomes.

Conclusion:

The American College of Surgeons' National Surgical Quality Improvement Program risk calculator was found to be effective in predicting post-operative complication rates in South Australian tongue cancer patients. However, significant discrepancies in predicted and actual length of stay may limit its use in this population.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented orally at the 13th Japan-Taiwan Conference on Otolaryngology Head and Neck Surgery Meeting, 3–4 December 2015, Tokyo, Japan.

References

1 Khuri, SF, Daley, J, Henderson, W, Hur, K, Demakis, J, Aust, JB et al. The Department of Veterans Affairs' NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program. Ann Surg 1998;228:491507 Google Scholar
2 Stachler, RJ, Yaremchuk, K, Ritz, J. Preliminary NSQIP results: a tool for quality improvement. Otolaryngol Head Neck Surg 2010;143:2630, e1–3Google Scholar
3 Ferlay, J, Shin, HR, Bray, F, Forman, D, Mathers, C, Parkin, DM. GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. Lyon: International Agency for Research on Cancer, 2010 Google Scholar
4 Chaturvedi, AK, Anderson, WF, Lortet-Tieulent, J, Curado, MP, Ferlay, J, Franceschi, S et al. Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers. J Clin Oncol 2013;31:4550–9Google Scholar
5 Carvalho, AL, Nishimoto, IN, Califano, JA, Kowalski, LP. Trends in incidence and prognosis for head and neck cancer in the United States: a site-specific analysis of the SEER database. Int J Cancer 2005;114:806–16Google Scholar
6 Bilimoria, KY, Liu, Y, Paruch, JL, Zhou, L, Kmiecik, TE, Ko, CY et al. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J Am Coll Surg 2013;217:833–42, e1–3Google Scholar
7 Chen, MM, Roman, SA, Sosa, JA, Judson, BL. Postdischarge complications predict reoperation and mortality after otolaryngologic surgery. Otolaryngol Head Neck Surg 2013;149:865–72Google Scholar
8 Russell, PT, Hakendorf, P, Thompson, CH. A general medical short-stay unit is not more efficient than a traditional model of care. Med J Aust 2014;200:482–4CrossRefGoogle Scholar
9 Australian Institute of Health and Welfare 2016. Hospital performance: relative stay index. In: http://www.aihw.gov.au/haag09-10/hospital-performance-relative-stay-index/ [17 February 2016]Google Scholar
10 Brier, GW. Verification of forecasts expressed in terms of probability. Monthly Weather Review 1950;78:13 Google Scholar
11 Steyerberg, EW, Vickers, AJ, Cook, NR, Gerds, T, Gonen, M, Obuchowski, N et al. Assessing the performance of prediction models: a framework for traditional and novel measures. Epidemiology 2010;21:128–38Google Scholar
12 Downey, RJ, Friedlander, P, Groeger, J, Kraus, D, Schantz, S, Spiro, R et al. Critical care for the severely ill head and neck patient. Crit Care Med 1999;27:95–7Google Scholar
13 de Melo, GM, Ribeiro, KC, Kowalski, LP, Deheinzelin, D. Risk factors for postoperative complications in oral cancer and their prognostic implications. Arch Otolaryngol Head Neck Surg 2001;127:828–33Google Scholar
14 Lewis, CM, Aloia, TA, Shi, W, Martin, I, Lai, SY, Selber, JC et al. Development and feasibility of a specialty-specific National Surgical Quality Improvement Program (NSQIP): the head and neck-reconstructive surgery NSQIP. JAMA Otolaryngol Head Neck Surg 2016;142:321–7Google Scholar
15 Frederick, JW, Sweeny, L, Carroll, WR, Peters, GE, Rosenthal, EL. Outcomes in head and neck reconstruction by surgical site and donor site. Laryngoscope 2013;123:1612–17Google Scholar
16 Hanasono, MM, Friel, MT, Klem, C, Hsu, PW, Robb, GL, Weber, RS et al. Impact of reconstructive microsurgery in patients with advanced oral cavity cancers. Head Neck 2009;31:1289–96Google Scholar
17 Schwam, ZG, Sosa, JA, Roman, S, Judson, BL. Complications and mortality following surgery for oral cavity cancer: analysis of 408 cases. Laryngoscope 2015;125:1869–73Google Scholar
18 Clark, JR, McCluskey, SA, Hall, F, Lipa, J, Neligan, P, Brown, D et al. Predictors of morbidity following free flap reconstruction for cancer of the head and neck. Head Neck 2007;29:1090–101Google Scholar
19 Rogers, SN, Lowe, D, Brown, JS, Vaughan, ED. The relationship between length of stay and health-related quality of life in patients treated by primary surgery for oral and oropharyngeal cancer. Int J Oral Maxillofac Surg 2001;30:209–15Google Scholar
20 Vega, C, Leon, X, Cervelli, D, Pons, G, Lopez, S, Fernandez, M et al. Total or subtotal glossectomy with microsurgical reconstruction: functional and oncological results. Microsurgery 2011;31:517–23Google Scholar
21 O'Brien, CJ, Nettle, WJ, Lee, KK. Changing trends in the management of carcinoma of the oral cavity and oropharynx. Aust N Z J Surg 1993;63:270–4Google Scholar
22 Gavriel, H, Thompson, E, Kleid, S, Chan, S, Sizeland, A. Safety of thromboprophylaxis after oncologic head and neck surgery. Study of 1018 patients. Head Neck 2013;35:1410–14Google Scholar
23 Robbins, KT, Favrot, S, Hanna, D, Cole, R. Risk of wound infection in patients with head and neck cancer. Head Neck 1990;12:143–8Google Scholar
24 Agra, IM, Carvalho, AL, Pontes, E, Campos, OD, Ulbrich, FS, Magrin, J et al. Postoperative complications after en bloc salvage surgery for head and neck cancer. Arch Otolaryngol Head Neck Surg 2003;129:1317–21Google Scholar
25 Lotfi, CJ, Cavalcanti Rde, C, Costa e Silva, AM, Latorre Mdo, R, Ribeiro Kde, C, Carvalho, AL et al. Risk factors for surgical-site infections in head and neck cancer surgery. Otolaryngol Head Neck Surg 2008;138:7480 Google Scholar
26 Velanovich, V. A meta-analysis of prophylactic antibiotics in head and neck surgery. Plast Reconstr Surg 1991;87:429–34; discussion 35Google Scholar
27 Simo, R, French, G. The use of prophylactic antibiotics in head and neck oncological surgery. Curr Opin Otolaryngol Head Neck Surg 2006;14:5561 Google Scholar
28 Kasperts, N, Slotman, B, Leemans, CR, Langendijk, JA. A review on re-irradiation for recurrent and second primary head and neck cancer. Oral Oncol 2005;41:225–43Google Scholar
29 Awad, MI, Shuman, AG, Montero, PH, Palmer, FL, Shah, JP, Patel, SG. Accuracy of administrative and clinical registry data in reporting postoperative complications after surgery for oral cavity squamous cell carcinoma. Head Neck 2015;37:851–61Google Scholar
30 Amendola, BE, Wolf, AL, Coy, SR, Amendola, MA. The use of radiosurgery for salvage in recurrent tumors of the skull base. Int Pediatr 2004;19:164–9Google Scholar
31 Kao, SS, Ooi, EH, Peters, MD. Swallowing outcomes following primary surgical resection and primary free flap reconstruction for oral and oropharyngeal squamous cell carcinomas: a systematic review protocol. JBI Database System Rev Implement Rep 2015;13:120–34Google Scholar
32 Kao, SS, Peters, MD, Krishnan, SG, Ooi, EH. Swallowing outcomes following primary surgical resection and primary free flap reconstruction for oral and oropharyngeal squamous cell carcinomas: a systematic review. Laryngoscope 2016;126:1572–80Google Scholar
33 Hatcher, JL, Bell, EB, Browne, JD, Waltonen, JD. Disposition of elderly patients after head and neck reconstruction. JAMA Otolaryngol Head Neck Surg 2013;139:1236–41Google Scholar