Is the American College of Surgeons National Surgical Quality Improvement Program surgical risk calculator applicable for breast cancer patients undergoing breast-conserving surgery?

被引：18

作者：

Lyle, Brian ^{[1
,2
]}

Landercasper, Jeffrey ^{[1
,3
]}

Johnson, Jeanne M. ^{[1
,3
]}

Al-Hamadani, Mohammed ^{[4
]}

Vang, Choua A. ^{[4
]}

Groshek, Jacqueline ^{[4
]}

Hennessy, Joy L. ^{[3
]}

Theede, Lonna M. ^{[3
]}

Zutavern, Kristin ^{[4
]}

Linebarger, Jared H. ^{[1
,3
]}

机构：

[1] Gundersen Hlth Syst, Dept Surg, 1900 South Ave, La Crosse, WI 54601 USA

[2] Gunderson Med Fdn, Dept Med Educ, La Crosse, WI USA

[3] Gundersen Hlth Syst, Norma J Vinger Ctr Breast Care, 1900 South Ave, La Crosse, WI 54601 USA

[4] Gunderson Med Fdn, Dept Med Res, La Crosse, WI USA

来源：

AMERICAN JOURNAL OF SURGERY | 2016年 / 211卷 / 04期

关键词：

Breast-conserving surgery; Lumpectomy; Morbidity; NSQIP risk calculator; Quality improvement; IRRADIATION; LUMPECTOMY; SOCIETY; TRIAL; WOMEN;

D O I：

10.1016/j.amjsurg.2015.07.013

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: We aimed to analyze the applicability of the National Surgical Quality Improvement Program (NSQIP) calculator to patients undergoing breast-conserving surgery. METHODS: A total of 287 consecutive patients treated with breast-conserving surgery from 2010 to 2012 were identified retrospectively. The risk calculator was applied to each patient to generate an individual risk profile. Risk calculations were then compared with actual outcomes. The performance of the risk calculator was evaluated using 2 metrics: the Brier score and c statistic. RESULTS: The NSQIP calculator performed adequately for all complications, with Brier scores less than .05. However, 37 patients (12.9%) returned to the operating room for oncologic indications. Twenty-nine patients (10.1%) had positive margins, whereas 8 patients (2.8%) returned due to an upgrade in diagnosis. CONCLUSIONS: When considering return to the operating room for oncologic management, the observed rate of 13.9% is significantly higher than the NSQIP prediction. This deviation must be addressed when using the NSQIP risk calculator model during preoperative risk discussion. (C) 2016 Elsevier Inc. All rights reserved.

引用

页码：820 / 823

页数：4

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