Head and Neck Surgery Risk Index (HNSRI)

Description

Mascarella et al reported the Head and Neck Surgery Risk Index (HNSRI) which can help to identify a head and neck cancer surgery patient who is at risk for adverse events. This can help to identify a patient who may benefit from more aggressive management. The authors are from McGill University.

Patient selection: adult undergoing head and neck cancer surgery

Parameters:

(1) age in years

(2) sex

(3) hypertension requiring therapy

(4) dyspnea

(5) long-term steroid use

(6) anticoagulation

(7) current smoker

(8) WBC count

(9) hematocrit

(10) serum albumin

(11) weight loss

(12) functional loss (physically dependent)

(13) surgical time in hours

(14) free-tissue transfer during surgery

(15) tracheostomy during surgery

(16) CDC wound class

Parameter	Finding	Points
age in years	< 50	0
	50 to 59	1
	60 to 69	3
	70 to 79	4
	80 to 89	4
	>= 90	11
sex	male	3
	female	0
hypertension	no	0
	yes	3
dyspnea	no	0
	yes	4
steroid use	no	0
	yes	4
anticoagulation	no	0
	yes	8
current smoker	no	0
	yes	5
WBC count	<= 11,500 per µL	0
	> 11,500 per µL	5
hematocrit	>= 35%	0
	< 35%	10
serum albumin	>= 3.5 g/dL	0
	< 3.5 g/dL	5
weight loss	no	0
	yes	7
functional loss	no	0
	yes	6
surgical time	< 4 hours	0
	4 to 8 hours	9
	> 8 hours	17
free-tissue transfer	no	0
	yes	7
tracheostomy	no	0
	yes	6
wound class	clean	0
	clean-contaminated	5
	contaminated	11
	dirty	15

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 116

• The higher the score the greater the risk of an adverse event within 30 days.

Score	Adverse Event
0 to 5	2%
6 to 10	4%
11 to 15	7%
16 to 20	11%
21 to 25	16%
26 to 30	23%
31 to 35	36%
36 to 40	42%
41 to 45	51%
46 to 50	63%
51 to 55	68%
56 to 60	78%
>= 61	80%

Performance:

• The area under the ROC curve is 0.84.

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Head and Neck Surgery Risk Index (HNSRI)

Description

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