| The Thoracic Surgery Scoring System (Thoracoscore): risk model for in-hospital death in 15,183 patients requiring thoracic surgery. | |
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MedLine Citation:
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PMID: 17258556 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: This study was undertaken to determine factors associated with in-hospital mortality among patients after general thoracic surgery and to construct a risk model. METHODS: Data from a nationally representative thoracic surgery database were collected prospectively between June 2002 and July 2005. Logistic regression analysis was used to predict the risk of in-hospital death. A risk model was developed with a training set of data (two thirds of patients) and validated on an independent test set (one third of patients). Model fit was assessed by the Hosmer-Lemeshow test; predictive accuracy was assessed by the c-index. RESULTS: Of the 15,183 original patients, 338 (2.2%) died during the same hospital admission. Within the data used to develop the model, these factors were found to be significantly associated with the occurrence of in-hospital death in a multivariate analysis: age, sex, dyspnea score, American Society of Anesthesiologists score, performance status classification, priority of surgery, diagnosis group, procedure class, and comorbid disease. The model was reliable (Hosmer-Lemeshow test 3.22; P = .92) and accurate, with a c-index of 0.85 (95% confidence interval 0.83-0.87) for the training set and 0.86 (95% confidence interval 0.83-0.89) for the test set of data. The correlation between the expected and observed number of deaths was 0.99. CONCLUSIONS: The validated multivariate model Thoracoscore, described in this report for risk of in-hospital death among adult patients after general thoracic surgery was developed with national data, uses only 9 variables, and has good performance characteristics. It appears to be a valid clinical tool for predicting the risk of death. |
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Authors:
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Pierre Emmanuel Falcoz; Massimo Conti; Laurent Brouchet; Sidney Chocron; Marc Puyraveau; Mariette Mercier; Joseph Philippe Etievent; Marcel Dahan |
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Publication Detail:
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Type: Journal Article Date: 2007-01-09 |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 133 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2007 Feb |
Date Detail:
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Created Date: 2007-01-29 Completed Date: 2007-02-23 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 325-32 Citation Subset: AIM; IM |
Affiliation:
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Department of Thoracic and Cardiovascular Surgery, Jean-Minjoz Hospital, Besançon, France. pierre-emmanuel.falcoz@wanadoo.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Distribution Aged Databases, Factual Female France Hospital Mortality* Humans Logistic Models Lung Diseases / diagnosis, mortality*, surgery* Male Middle Aged Models, Statistical* Multicenter Studies as Topic Multivariate Analysis Probability Prospective Studies Risk Assessment Severity of Illness Index Sex Distribution Survival Analysis Thoracic Surgical Procedures / methods, mortality* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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