Published in:
Open Access 01-05-2021 | Sinus Surgery | Rhinology
Preoperative risk assessment for ambulatory sinonasal surgery
Published in: European Archives of Oto-Rhino-Laryngology | Issue 5/2021
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Objectives
An increasing proportion of patients who are candidates for endoscopic sinus surgery can be treated as an outpatient. A preoperative risk assessment is needed to evaluate eligibility for day surgery. This study analyses the effectiveness of a risk assessment scoring system which examines medical, procedure-related, and socioeconomic factors.
Design
Prospective multicenter study.
Setting
Three center study including Klinik Hirslanden, Zurich, Switzerland, Luzerner Kantonsspital, Lucerne, Switzerland and HNO-Klinik München-Bogenhausen, Munich, Germany.
Participants
Patients with endoscopic sinus procedures between January 1st, 2017 and December 31st, 2018.
Main outcome measures
The “day surgery risk score” consisted of three subgroups with medical, procedure-related and socioeconomic risk factors were assessed to determine if these predicted the severity of postoperative complications.
Results
Three-hundred and one patients who underwent endoscopic sinus surgery were included. The score resulted in a median value of 5 [5, 5]. In the Receiver-Operating Curve (ROC—the true-positive rate against the false-positive rate), the Area Under the Curve (AUC) was 0.59 with 95% confidence interval from 0.49 to 0.69, indicating that the “day surgery risk score” may be no better at predicting the likelihood of a complication than a random classification model.
Conclusions
The “day surgery risk score” is a straightforward risk assessment which combines medical, procedure-related, and socioeconomic factors. The score is easy to use but in trying to decide whether a patient is eligible for ambulatory endoscopic sinus surgery it did not predict whether a complication was more likely to occur.