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

  • Narayana Subramaniam
  • Deepak Balasubramanian
  • Pradeep RKA
  • Samskruthi Murthy
  • Priyank Rathod
  • Sivakumar Vidhyadharan
  • Krishnakumar Thankappan
  • Subramania Iyer
Original Article

Abstract

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 r 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 r value for length of stay was also not significant (p = .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.

Keywords

Head and neck cancer Risk assessment ACSNSQIP 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

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Copyright information

© Indian Association of Surgical Oncology 2018

Authors and Affiliations

  • Narayana Subramaniam
    • 1
  • Deepak Balasubramanian
    • 1
  • Pradeep RKA
    • 2
  • Samskruthi Murthy
    • 1
  • Priyank Rathod
    • 1
  • Sivakumar Vidhyadharan
    • 1
  • Krishnakumar Thankappan
    • 1
  • Subramania Iyer
    • 1
  1. 1.Department of Head and Neck Oncology, Amrita Institute of Medical SciencesAmrita Vishwa VidyapeethamKochiIndia
  2. 2.Department of Otorhinolaryngology, Amrita Institute of Medical SciencesAmrita Vishwa VidyapeethamKochiIndia

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