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Am J Surg ; 211(4): 820-3, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26489987

RESUMO

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.


Assuntos
Neoplasias da Mama/cirurgia , Mastectomia Segmentar , Garantia da Qualidade dos Cuidados de Saúde/métodos , Medição de Risco , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Melhoria de Qualidade , Sistema de Registros , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Sociedades Médicas , Estados Unidos
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