External validation of the modified Thoracoscore in a new thoracic surgery program: prediction of in-hospital mortality

Abstract

Informed consent prior to any surgical intervention should include in-hospital survival estimation after the procedure performed. The recently developed Thoracoscore predicts well the postoperative mortality possibility. The purpose of our study was to test the modified Thoracoscore performance in our new thoracic program. One hundred and fifty-five consecutive patients underwent thoracic surgery procedure within two years. The procedures performed were: 62 lung resections, 10 open tumor biopsies, 21 neck and mediastinal procedures, 33 chest wall and pleural procedures, 8 tracheal procedures, 3 esophageal procedures, 13 minor cardiac procedures, and 5 chest trauma cases. The modified Thoracoscore was calculated based on the following variables: age, gender, priority of the procedure, malignancy, type of procedure, Zubrod score, ASA class, and number of co-morbidities. The observed mortality was 5.2% (eight deaths) while the predicted one based on the modified Thoracoscore was 4.9%. The scoring system we used had excellent discriminatory ability with a C statistic (0.95, 95% CIs 0.91-0.99). The Hosmer-Lemeshow goodness-of-fit was not statistically significant (P=0.82), indicating acceptable calibration of the model for the present series. The modified Thoracoscore's ability to predict postoperative survival in the whole context of thoracic surgery performs well in our program. Application of any risk scoring system requires external validation and provides comparison of the actual outcomes with other programs.

Preoperative Exercise Testing Is a Better Predictor of Postoperative Complications than Pulmonary Function Testing for Patients with Lung Cancer

“…These standards are meaningful but not always predictive of the development of PCPCs without the addition of other tests [13]. Various tests and scoring systems have been reported [14]- [18]. A modified Thoracoscore, which predicts postoperative outcomes after thoracic surgery, can be calculated based on the following variables: age, gender, priority of the procedure, malignancy, type of procedure, Zubrod score, ASA class, and number of co-morbidities [18].…”

“…Various tests and scoring systems have been reported [14]- [18]. A modified Thoracoscore, which predicts postoperative outcomes after thoracic surgery, can be calculated based on the following variables: age, gender, priority of the procedure, malignancy, type of procedure, Zubrod score, ASA class, and number of co-morbidities [18]. However, such a scoring system is difficult to use on a daily basis in clinical practice.…”

A retrospective analysis of high-risk patients for mediastinoscopy

“…Plaisier ve ark.nın [9] Göğüs cerrahisi ameliyatlarında ASA skoru, ameliyat sırası mortalite ve morbidite için iyi bir belirleyicidir. [13,14] Küçük ve orta cerrahi girişimlerin normal fizyolojiyi olumsuz etkilemesi düşük bir ihtimal iken, büyük cerrahi girişimlerde normal fizyoloji anlamlı oranda bozulmaktadır. Skúladóttir ve ark.…”

Umfassende präoperative Evaluation von Patienten mit Lungenkrebs

“…Auch die meisten komplexen prädiktiven Modelle wie etwa der European Society Objective Score (ESOS) beinhalten eine zu geringe Anzahl an Verstorbenen (n = 66) [ [9]. Auch 2 Validierungsstudien mit US-amerikanischen Patienten bestätigten die guten Prädiktionswerte des Scores [10,11].…”