Can the ACS‐NSQIP surgical risk calculator predict postoperative complications in patients undergoing sacral tumor resection for chordoma?

摘要

Abstract Background and Objectives The ACS‐NSQIP surgical risk calculator is an online tool that estimates the risk of postoperative complications. Sacrectomies for chordoma are associated with a high rate of complications. This study was to determine if the ACS‐NSQIP calculator can predict postoperative complications following sacrectomy. Methods Sixty‐five (42 male, 23 female) patients who underwent sacrectomy were analyzed using the Current Procedural Terminology (CPT) codes: 49215 (excision of presacral/sacral tumor), 63001 (laminectomy of sacral vertebrae), 63728 (laminectomy for biopsy/excision of sacral neoplasm) and 63307 (sacral vertebral corpectomy for intraspinal lesion). The predicted rates of complications were compared to the observed rates. Results Complications were noted in 44 (68%) patients. Of the risk factors available to input to the ACS‐NSQIP calculator, tobacco use (OR, 20.4; P ??.001) was predictive of complications. The predicted risk of complications based off the CPT codes were: 49215 (16%); 63011 (6%); 63278 (11%) and 63307 (15%). Based on ROC curves, the use of the ACS‐NSQIP score were poor predictors of complications (49215, AUC 0.65); (63011, AUC 0.66); (63307, AUC 0.67); (63278, AUC 0.64). Conclusion The ACS‐NSQIP calculator was a poor predictor of complications and was marginally better than a coin flip in its ability to predict complications following sacrectomy for chordoma.