NSQIP Surgical Risk Calculator: Is it right for OTO-HNS

The views expressed are those of the authors and do not reflect the official views of the Department of Defense or its Components. Objective Hypothesis. The American College of Surgeons ACS National Surgery Quality Improvement Program NSQIP Surgery Risk Calculator SRC, initially designed and calibrated for colorectal surgery cases and later revised to include all major surgical cases, has not been calibrated for Otolaryngology Head and Neck OTO-HNS surgeries. Over the last several years, published studies have reported on the Surgery Risk Calculators ability to predict peri-operative outcomes specific to OTO-HNS surgeries, with mixed results. We hypothesize that current literature supports the NSQIP SRC as accurate and applicable to OTO-HNS surgeries. Study Design. Systematic Review Methods. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statement, a systematic review of the literature was performed over four databases, yielding 2,827 original articles. The authors reviewed all articles, five of which ultimately met inclusion criteria and were analyzed. Results. Data from 525 patients undergoing head and neck free flap reconstruction, total thyroidectomy, partial and hemiglossectomy, total glossectomy, total laryngectomy, laryngopharyngectomy, and composite resection were evaluated. Predicted rates were compared to actual rates for a total of 13 patient outcome variables, including any complication, mortality, return to Operating Room, and readmission. We found no correlation between rates predicted by the SRC and actual outcomes for the vast majority of measures reported on. Conclusions. The current NSQIP Surgical Risk Calculator appears to be inaccurate in estimating perioperative risk for evaluated OTO-HNS surgeries.