NSQIP作为游离皮瓣重建患者住院时间的预测指标
NSQIP as a Predictor of Length of Stay in Patients Undergoing Free Flap Reconstruction.
作者信息
Riley Charles A, Barton Blair M, Lawlor Claire M, Cai David Z, Riley Phoebe E, McCoul Edward D, Hasney Christian P, Moore Brian A
机构信息
Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Department of Otorhinolaryngology, Ochsner Clinic Foundation, New Orleans, Louisiana, USA.
出版信息
OTO Open. 2017 Jan 18;1(1):2473974X16685692. doi: 10.1177/2473974X16685692. eCollection 2017 Jan-Mar.
OBJECTIVE
The National Surgical Quality Improvement Program (NSQIP) calculator was created to improve outcomes and guide cost-effective care in surgery. Patients with head and neck cancer (HNC) undergo ablative and free flap reconstructive surgery with prolonged postoperative courses.
METHODS
A case series with chart review was performed on 50 consecutive patients with HNC undergoing ablative and reconstructive free flap surgery from October 2014 to March 2016 at a tertiary care center. Comorbidities and intraoperative and postoperative variables were collected. Predicted length of stay was tabulated with the NSQIP calculator.
RESULTS
Thirty-five patients (70%) were male. The mean (SD) age was 67.2 (13.4) years. The mean (SD) length of stay (LOS) was 13.5 (10.3) days. The mean (SD) NSQIP-predicted LOS was 10.3 (2.2) days ( = .027).
DISCUSSION
The NSQIP calculator may be an inadequate predictor for LOS in patients with HNC undergoing free flap surgery. Additional study is necessary to determine the accuracy of this tool in this patient population.
IMPLICATIONS FOR PRACTICE
Head and neck surgeons performing free flap reconstructive surgery following tumor ablation may find that the NSQIP risk calculator underestimates the LOS in this population.
目的
国家外科质量改进计划（NSQIP）计算器旨在改善手术效果并指导具有成本效益的手术治疗。头颈癌（HNC）患者需接受切除及游离皮瓣重建手术，术后病程较长。
方法
对2014年10月至2016年3月在一家三级医疗中心连续接受切除及游离皮瓣重建手术的50例HNC患者进行了病例系列研究及病历回顾。收集了合并症以及术中与术后变量。使用NSQIP计算器列出预测住院时间。
结果
35例患者（70%）为男性。平均（标准差）年龄为67.2（13.4）岁。平均（标准差）住院时间（LOS）为13.5（10.3）天。NSQIP预测的平均（标准差）LOS为10.3（2.2）天（P = 0.027）。
讨论
NSQIP计算器对于接受游离皮瓣手术的HNC患者的LOS可能是一个不充分的预测指标。需要进一步研究以确定该工具在这一患者群体中的准确性。
对实践的启示
进行肿瘤切除术后游离皮瓣重建手术的头颈外科医生可能会发现，NSQIP风险计算器低估了该群体的LOS。
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