Optimizing classical risk scores to predict complications in head and neck surgery: a new approach.

Autor: Sousa Menezes, Ana, Fernandes, Antero, Rocha Rodrigues, Jéssica, Salomé, Carla, Machado, Firmino, Antunes, Luís, Castro Silva, Joaquim, Monteiro, Eurico, Lara Santos, Lúcio
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Zdroj: European Archives of Oto-Rhino-Laryngology; 2021, Vol. 278 Issue 1, p191-202, 12p
Abstrakt: Purpose: To validate tools to identify patients at risk for perioperative complications to implement prehabilitation programmes in head and neck surgery (H&N). Methods: Retrospective cohort including 128 patients submitted to H&N, with postoperative Intermediate Care Unit admittance. The accuracy of the risk calculators ASA, P-POSSUM, ACS-NSQIP and ARISCAT to predict postoperative complications and mortality was assessed. A multivariable analysis was subsequently performed to create a new risk prediction model for serious postoperative complications in our institution. Results: Our 30-day morbidity and mortality were 45.3% and 0.8%, respectively. The ACS-NSQIP failed to predict complications and had an acceptable discrimination ability for predicting death. The discrimination ability of ARISCAT for predicting respiratory complications was acceptable. ASA and P-POSSUM were poor predictors for mortality and morbidity. Our new prediction model included ACS-NSQIP and ARISCAT (area under the curve 0.750, 95% confidence intervals: 0.63–0.87). Conclusion: Despite the insufficient value of these risk calculators when analysed individually, we designed a risk tool combining them which better predicts the risk of serious complications. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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