Document Detail

The Thoracic Surgery Scoring System (Thoracoscore): risk model for in-hospital death in 15,183 patients requiring thoracic surgery.
MedLine Citation:
PMID:  17258556     Owner:  NLM     Status:  MEDLINE    
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.
Pierre Emmanuel Falcoz; Massimo Conti; Laurent Brouchet; Sidney Chocron; Marc Puyraveau; Mariette Mercier; Joseph Philippe Etievent; Marcel Dahan
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Publication Detail:
Type:  Journal Article     Date:  2007-01-09
Journal Detail:
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:
Created Date:  2007-01-29     Completed Date:  2007-02-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  325-32     Citation Subset:  AIM; IM    
Department of Thoracic and Cardiovascular Surgery, Jean-Minjoz Hospital, Besançon, France.
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MeSH Terms
Age Distribution
Databases, Factual
Hospital Mortality*
Logistic Models
Lung Diseases / diagnosis,  mortality*,  surgery*
Middle Aged
Models, Statistical*
Multicenter Studies as Topic
Multivariate Analysis
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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