在接受头部和部微血管重建的老年患者中预测术后并发症使用国家质量改进计划风险计算器
Sebastian Holm1,2, Jenny Löfgren3,4, Johann Zdolsek1,2
1From the Department of Plastic and Reconstructive Surgery, Örebro University Hospital, Örebro, Sweden.
Plastic and reconstructive surgery. Global open
|June 27, 2025
概括
国家外科质量改善计划 (NSQIP) 风险计算器低估了接受微血管重建的头癌 (HNC) 患者的并发症. 这个工具需要改进,以便在HNC外科病例中准确预测.
科学领域:
- 在瘤学瘤学.
- 外科手术的结果
- 医疗信息学 医疗信息学
背景情况:
- 头癌 (HNC) 是一种普遍存在的全球性恶性瘤,需要多学科治疗.
- 国家外科质量改善计划 (NSQIP) 的风险计算器有助于预测术后并发症.
- 它在微血管重建的HNC手术中的实用性需要验证.
研究的目的:
- 评估NSQIP风险计算器在预测术后并发症方面的准确性.
- 为了评估计算器的可靠性,患者进行头癌切除与微血管重建.
主要方法:
- 对99名接受微血管重建的HNC患者的回顾性分析 (2016年1月至2021年2月).
- 观察到的术后并发症与NSQIP计算器预测的比较.
- 使用接收器运行特征 (ROC) 曲线和Brier分数的统计分析.
主要成果:
- 44%的患者出现并发症;27.2%有严重的并发症.
- ROC分析显示,任何并发症的曲线下面面积 (AUC) 为0.62,严重并发症为0.65.
- 这两种AUC值都低于可接受歧视的值 (0.7-0.8).
结论:
- NSQIP风险计算器低估了接受微血管重建的HNC患者的并发症可能性.
- 该工具的预测准确性对于这种特定的手术群体是有限的.
- 对于HNC手术,需要进一步完善风险预测模型.
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