Postoperative Mortality After Esophagectomy for Cancer: Development of a Preoperative Risk Prediction Model

Abstract

Postoperative mortality (30-day and in-hospital) remains high after esophagectomy. Age, Charlson score, and hospital volume were identified as independent predictors of postoperative mortality. A simple risk prediction model that uses preoperative clinical data accurately predicted patient postoperative mortality for this SEER-Medicare population.

The Impact of Age on Morbidity and Mortality following Esophagectomy for Esophageal Cancer

“…However, wound, cardiac, reoperations, and sepsis were not risk factors (P = not signifi cant) among any groups. Ra et al 48 used a conglomeration of metrics to calculate risk. They utilized a combination of the Charlson comorbidity index, age, and hospital volume to predict postoperative mortality.…”

Risk Prediction Scores for Postoperative Mortality After Esophagectomy: Validation of Different Models

“…Both models accurately predicted postoperative mortality in initial reports. 12,14 The time period over which the patients were collected was long for three of the scores (22 years in the Rotterdam score, 14 years in the Munich score, and 15 years in the ASA score), whereas the data for the validation of the Philadelphia score were collected over a 6-year period.…”

“…Steyerberg et al 11 from Rotterdam, the Netherlands, developed a simple score which included age, comorbidity, hospital volume, and whether the patient received neoadjuvant treatment. Very similar, but without using neoadjuvant treatment a as variable, is the recently described prediction model of Ra et al 12 from Philadelphia. Siewert's group 13 in Munich proposed a score based on pulmonary, hepatic, and cardiac function as well as on general status.…”

Gastrointestinal reconstructions in 1200 patients with cancer at the pharyngesophageal junction

“…Postoperative mortality was defined as 30-day mortality plus later inhospital postoperative deaths [42]. Postoperative complications were divided into a surgical and non-surgical section.…”