Bedside Risk Tool Determines Risk for Unexpected Admission After Outpatient Skin Cancer Reconstruction

WEDNESDAY, Nov. 11, 2026 (HealthDay News) -- A bedside risk score to determine unexpected admission after planned outpatient nonmelanoma skin cancer (NMSC) reconstruction yields satisfactory discrimination and calibration and may aid preoperative triage and resource planning for this population, according to a study recently published online in JPRAS.Thomas Schaschinger, from the University of Heidelberg in Germany, and colleagues quantified the incidence and risk factors associated with unexpected admission or prolonged observation after planned outpatient NMSC reconstruction, and using this information, they derived a simplified bedside risk score. Reconstruction with a postoperative NMSC diagnosis was identified from the American College of Surgeons National Surgical Quality Improvement Program database (2008 to 2023); independent associations were identified in pooled multivariable logistic regression.The researchers found that 779 of the 5,371 patients required unexpected admission (14.5 percent). Independent associations were identified, including operative complexity (adjusted odds ratios, 7.59 and 20.76, respectively, for regional myocutaneous flap and for free flap, nodal, and salivary or bone resection), anesthesia type (substantially lower odds for local anesthesia and monitored anesthesia care relative to general anesthesia), higher American Society of Anesthesiologists physical status, chronic corticosteroid use, and dependent functional status. An optimism-corrected area under the receiver operating characteristic curve (AUC) of 0.789 was achieved with the regression model; calibration was excellent (corrected slope, 0.966). Comparable discrimination was retained with the simplified integer score (AUC, 0.778); stratified observed admission rates increased about 40-fold from 2.0 to 79.0 percent with score ≤0 and ≥10, respectively."Pending external validation, this tool may support preoperative triage, resource planning, and shared decision-making in a growing and predominantly older surgical population," the authors write.Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter

Bedside Risk Tool Determines Risk for Unexpected Admission After Outpatient Skin Cancer Reconstruction

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