• Yue Ma, Benjamin M Laitman, Vir Patel, Marita Teng, Eric Genden, Samuel DeMaria, and Brett A Miles.
• 1 Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
• Otolaryngol Head Neck Surg. 2019 Jan 1; 160 (1): 100-106.

ObjectiveThis study evaluated the accuracy of the Surgical Risk Calculator (SRC) of the ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Program) in predicting head and neck microvascular reconstruction outcomes.Study DesignRetrospective analysis.SettingTertiary medical center.Subjects And MethodsA total of 561 free flaps were included in the analysis. The SRC-predicted 30-day rates of postoperative complications, hospital length of stay (LOS), and rehabilitation discharge were compared with the actual rates and events. The SRC's predictive value was examined with Brier scores and receiver operating characteristic area under the curve.ResultsA total of 425 myocutaneous, 134 osseous (84 fibula, 47 scapula, and 3 iliac crest), and 2 omental free flaps were included in this study. All perioperative complications evaluated had area under the curve values ≤0.75, ranging from 0.480 to 0.728. All but 2 postoperative complications had Brier scores >0.01. SRC-predicted LOS was 9.4 ± 2.38 days (mean ± SD), which did not strongly correlate with the actual LOS of 11.98 ± 9.30 days ( r = 0.174, P < .0001).ConclusionThe SRC is a poor predictor for surgical outcome among patients undergoing microvascular head and neck reconstruction.

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