Brian Lyle1, Jeffrey Landercasper2, Jeanne M Johnson2, Mohammed Al-Hamadani3, Choua A Vang3, Jacqueline Groshek3, Joy L Hennessy4, Lonna M Theede4, Kristin Zutavern3, Jared H Linebarger5. 1. Department of Surgery, Gundersen Health System, 1900 South Avenue, La Crosse, WI, 54601, USA; Department of Medical Education, Gundersen Medical Foundation, La Crosse, WI, USA. 2. Department of Surgery, Gundersen Health System, 1900 South Avenue, La Crosse, WI, 54601, USA; Norma J. Vinger Center for Breast Care, Gundersen Health System, 1900 South Avenue, La Crosse, WI, 54601, USA. 3. Department of Medical Research, Gundersen Medical Foundation, La Crosse, WI, USA. 4. Norma J. Vinger Center for Breast Care, Gundersen Health System, 1900 South Avenue, La Crosse, WI, 54601, USA. 5. Department of Surgery, Gundersen Health System, 1900 South Avenue, La Crosse, WI, 54601, USA; Norma J. Vinger Center for Breast Care, Gundersen Health System, 1900 South Avenue, La Crosse, WI, 54601, USA. Electronic address: jhlineba@gundersenhealth.org.
Abstract
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.
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.
Authors: Trevor D Hamilton; Alyson L Mahar; Barbara Haas; Kaitlyn Beyfuss; Calvin H L Law; Paul J Karanicolas; Natalie G Coburn; Julie Hallet Journal: Gastric Cancer Date: 2017-12-11 Impact factor: 7.370
Authors: Jan van Schaik; Tessa M Hers; Carla Sp van Rijswijk; Maaike S Schooneveldt; Hein Putter; Daniël Eefting; Joost R van der Vorst Journal: JRSM Cardiovasc Dis Date: 2021-04-08