Accuracy of administrative and clinical registry data in reporting postoperative complications after surgery for oral cavity squamous cell carcinoma

Head Neck. 2015 Jun;37(6):851-61. doi: 10.1002/hed.23682. Epub 2014 Jun 27.

Abstract

Background: The purpose of this study was to describe and compare how postoperative complications after oral cavity squamous cell carcinoma (SCC) surgery are reported in medical records, institutional billing claims, and national clinical registries.

Methods: The medical records of 355 previously untreated patients who underwent surgery for oral cavity SCC at our institution were retrospectively reviewed for postoperative complications. Information was compared with claims and National Surgical Quality Improvement Program (NSQIP) data.

Results: We identified 219 patients (62%) experiencing 544 complications (10% major). Billing claims identified 29% of these patients, 36% of overall complications, and 98% of major complications. Of overlapping patients, NSQIP identified 27% of patients, 33% of overall complications, and 100% of major complications noted on chart abstraction.

Conclusion: The incidence of minor postoperative complications after oral cavity SCC surgery is relatively high. Both claims data and NSQIP accurately recorded major complications, but were suboptimal compared to chart abstraction in capturing minor complications.

Keywords: International Classification of Disease 9th edition (ICD)-9 codes; National Surgical Quality Improvement Program (NSQIP); head and neck cancer; postoperative complications; quality.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Incidence
  • Insurance Claim Reporting / statistics & numerical data
  • Male
  • Medical Records / statistics & numerical data
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / pathology
  • Quality Improvement
  • Registries / statistics & numerical data*
  • Sensitivity and Specificity
  • Survival Analysis
  • United States