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Optimizing classical risk scores to predict complications in head and neck surgery: a new approach.
Sousa Menezes, Ana; Fernandes, Antero; Rocha Rodrigues, Jéssica; Salomé, Carla; Machado, Firmino; Antunes, Luís; Castro Silva, Joaquim; Monteiro, Eurico; Lara Santos, Lúcio.
Afiliación
  • Sousa Menezes A; Department of Otorhinolaryngology-Head and Neck Surgery, Hospital De Braga, Sete Fontes - São Victor, 4710-243, Braga, Portugal. ana4644@gmail.com.
  • Fernandes A; Polyvalent Intensive Care Unit, Hospital Garcia de Orta, E.P.E, Almada, Portugal.
  • Rocha Rodrigues J; Department of Epidemiology, Portuguese Institute of Oncology of Porto FG (IPO-Porto), Porto, Portugal.
  • Salomé C; Surgical Intermediate Care Unit, Portuguese Institute of Oncology of Porto FG (IPO-Porto), Porto, Portugal.
  • Machado F; Department of Public Health Unit, ACES Porto Ocidental, Porto, Portugal.
  • Antunes L; Department of Epidemiology, Portuguese Institute of Oncology of Porto FG (IPO-Porto), Porto, Portugal.
  • Castro Silva J; Cancer Epidemiology Group, IPO Porto Research Center (CI-IPOP), Portuguese Institute of Oncology of Porto FG (IPO-Porto), Porto, Portugal.
  • Monteiro E; Department of Otorhinolaryngology-Head and Neck Surgery, Portuguese Institute of Oncology of Porto FG (IPO-Porto), Porto, Portugal.
  • Lara Santos L; Department of Otorhinolaryngology-Head and Neck Surgery, Portuguese Institute of Oncology of Porto FG (IPO-Porto), Porto, Portugal.
Eur Arch Otorhinolaryngol ; 278(1): 191-202, 2021 Jan.
Article en En | MEDLINE | ID: mdl-32556466
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Portugal Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Portugal Pais de publicación: Alemania