| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2005;28:306-311
© 2005 Elsevier Science NL
Original articles |
a Royal Devon & Exeter NHS Trust Barrack Road, Exeter, Devon EX2 5DW, UK
b Unit of Thoracic Surgery, ‘Umberto I°’ Regional Hospital, Ancona, via S. Margherita 23, Ancona 60129, Italy
c National Cancer Institute, Pascale, Via M Semmola 81, Naples 80131, Italy
d Guy's Hospital, London SE1 9RT, UK
e Clinical Operational Research Unit, UCL, London WC1E, UK
Received 17 December 2004; received in revised form 9 March 2005; accepted 15 March 2005.
* Corresponding author. Tel.: +44 207 188 7188; fax: +44 207 7018737. (Email: tom.treasure{at}ukgateway.net).
Abstract
Objective: To identify pre-operative factors associated with in-hospital mortality following lung resection and to construct a risk model that could be used prospectively to inform decisions and retrospectively to enable fair comparisons of outcomes. Methods: Data were submitted to the European Thoracic Surgery Database from 27 units in 14 countries. We analysed data concerning all patients that had a lung resection. Logistic regression was used with a random sample of 60% of cases to identify pre-operative factors associated with in-hospital mortality and to build a model of risk. The resulting model was tested on the remaining 40% of patients. A second model based on age and ppoFEV1% was developed for risk of in-hospital death amongst tumour resection patients. Results: Of the 3426 adult patients that had a first lung resection for whom mortality data were available, 66 died within the same hospital admission. Within the data used for model development, dyspnoea (according to the Medical Research Council classification), ASA (American Society of Anaesthesiologists) score, class of procedure and age were found to be significantly associated with in-hospital death in a multivariate analysis. The logistic model developed on these data displayed predictive value when tested on the remaining data. Conclusions: Two models of the risk of in-hospital death amongst adult patients undergoing lung resection have been developed. The models show predictive value and can be used to discern between high-risk and low-risk patients. Amongst the test data, the model developed for all diagnoses performed well at low risk, underestimated mortality at medium risk and overestimated mortality at high risk. The second model for resection of lung neoplasms was developed after establishing the performance of the first model and so could not be tested robustly. That said, we were encouraged by its performance over the entire range of estimated risk. The first of these two models could be regarded as an evaluation based on clinically available criteria while the second uses data obtained from objective measurement. We are optimistic that further model development and testing will provide a tool suitable for case mix adjustment.
Key Words: Lung resection • Risk modelling • In-hospital mortality • Lung cancer
This article has been cited by other articles:
|
|
 |
|
  A. Brunelli, A. Charloux, C. T. Bolliger, G. Rocco, J-P. Sculier, G. Varela, M. Licker, M. K. Ferguson, C. Faivre-Finn, R. M. Huber, et al. ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy) Eur. Respir. J., July 1, 2009; 34(1): 17 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Brunelli, R. G. Berrisford, G. Rocco, G. Varela, and on behalf of the European Society of Thoracic Surg The European Thoracic Database project: composite performance score to measure quality of care after major lung resection Eur. J. Cardiothorac. Surg., May 1, 2009; 35(5): 769 - 774. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Treasure Are randomised trials needed in the era of rapidly evolving technologies? Eur. J. Cardiothorac. Surg., March 1, 2009; 35(3): 474 - 478. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Salati, A. Brunelli, F. Xiume, M. Refai, and A. Sabbatini Quality of life in the elderly after major lung resection for lung cancer Interactive CardioVascular and Thoracic Surgery, January 1, 2009; 8(1): 79 - 83. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K. Ferguson, J. Siddique, and T. Karrison Modeling major lung resection outcomes using classification trees and multiple imputation techniques Eur. J. Cardiothorac. Surg., November 1, 2008; 34(5): 1085 - 1089. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Brunelli, M. Refai, F. Xiume, M. Salati, V. Sciarra, L. Socci, and A. Sabbatini Performance at Symptom-Limited Stair-Climbing Test is Associated With Increased Cardiopulmonary Complications, Mortality, and Costs After Major Lung Resection Ann. Thorac. Surg., July 1, 2008; 86(1): 240 - 248. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. D. Wright, H. A. Gaissert, J. D. Grab, S. M. O'Brien, E. D. Peterson, and M. S. Allen Predictors of Prolonged Length of Stay after Lobectomy for Lung Cancer: A Society of Thoracic Surgeons General Thoracic Surgery Database Risk-Adjustment Model Ann. Thorac. Surg., June 1, 2008; 85(6): 1857 - 1865. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K. Ferguson and W. T. Vigneswaran Diffusing Capacity Predicts Morbidity After Lung Resection in Patients Without Obstructive Lung Disease Ann. Thorac. Surg., April 1, 2008; 85(4): 1158 - 1165. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, G. Varela, P. Van Schil, M. Salati, N. Novoa, J. M. Hendriks, M. F. Jimenez, P. Lauwers, and on behalf of the ESTS Audit and Clinical Excellenc Multicentric analysis of performance after major lung resections by using the European Society Objective Score (ESOS) Eur. J. Cardiothorac. Surg., February 1, 2008; 33(2): 284 - 288. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, M. Refai, F. Xiume, M. Salati, R. Marasco, V. Sciarra, L. Socci, and A. Sabbatini Oxygen desaturation during maximal stair-climbing test and postoperative complications after major lung resections Eur. J. Cardiothorac. Surg., January 1, 2008; 33(1): 77 - 82. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, L. Socci, M. Refai, M. Salati, F. Xiume, and A. Sabbatini Quality of Life Before and After Major Lung Resection for Lung Cancer: A Prospective Follow-Up Analysis Ann. Thorac. Surg., August 1, 2007; 84(2): 410 - 416. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Varela, A. Brunelli, G. Rocco, M. F. Jimenez, M. Salati, and T. Gatani Evidence of Lower Alteration of Expiratory Volume in Patients With Airflow Limitation in the Immediate Period After Lobectomy Ann. Thorac. Surg., August 1, 2007; 84(2): 417 - 422. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Varela, A. Brunelli, G. Rocco, N. Novoa, M. Refai, M. F. Jimenez, M. Salati, and T. Gatani Measured FEV1 in the first postoperative day, and not ppoFEV1, is the best predictor of cardio-respiratory morbidity after lung resection Eur. J. Cardiothorac. Surg., March 1, 2007; 31(3): 518 - 521. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. E. Falcoz, M. Conti, L. Brouchet, S. Chocron, M. Puyraveau, M. Mercier, J. P. Etievent, and M. Dahan The Thoracic Surgery Scoring System (Thoracoscore): Risk model for in-hospital death in 15,183 patients requiring thoracic surgery J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 325 - 332. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, N. J. Morgan-Hughes, M. Refai, M. Salati, A. Sabbatini, and G. Rocco Risk-adjusted morbidity and mortality models to compare the performance of two units after major lung resections J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 88 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. G. Memtsoudis, M. C. Besculides, L. Zellos, N. Patil, and S. O. Rogers Trends in lung surgery: United States 1988 to 2002. Chest, November 1, 2006; 130(5): 1462 - 1470. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Varela, A. Brunelli, G. Rocco, R. Marasco, M. F. Jimenez, V. Sciarra, J. L. Aranda, and T. Gatani Predicted versus observed FEV1 in the immediate postoperative period after pulmonary lobectomy. Eur. J. Cardiothorac. Surg., October 1, 2006; 30(4): 644 - 648. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, F. Xiume, M. Refai, and A. Sabbatini Bilateral staged uniportal VATS for synchronous lung cancers Interactive CardioVascular and Thoracic Surgery, October 1, 2006; 5(5): 658 - 659. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli and G. Rocco Reply to pramesh and mistry. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 203 - 203. [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, F. Xiume', M. Al Refai, M. Salati, R. Marasco, and A. Sabbatini Gemcitabine-Cisplatin Chemotherapy Before Lung Resection: A Case-Matched Analysis of Early Outcome Ann. Thorac. Surg., June 1, 2006; 81(6): 1963 - 1968. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Garzon, C. S.H. Ng, A. D.L. Sihoe, A. V. Manlulu, R. H.L. Wong, T. W. Lee, and A. P.C. Yim Video-Assisted Thoracic Surgery Pulmonary Resection for Lung Cancer in Patients with Poor Lung Function Ann. Thorac. Surg., June 1, 2006; 81(6): 1996 - 2003. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli and G. Rocco Internal validation of risk models in lung resection surgery: Bootstrap versus training-and-test sampling J. Thorac. Cardiovasc. Surg., June 1, 2006; 131(6): 1243 - 1247. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Gallivan, M. Utley, D. Pagano, and T. Treasure MADCAP: a graphical method for assessing risk scoring systems. Eur. J. Cardiothorac. Surg., April 1, 2006; 29(4): 431 - 433. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, M. A. Refai, M. Salati, A. Sabbatini, N. J. Morgan-Hughes, and G. Rocco Carbon monoxide lung diffusion capacity improves risk stratification in patients without airflow limitation: evidence for systematic measurement before lung resection. Eur. J. Cardiothorac. Surg., April 1, 2006; 29(4): 567 - 570. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Brunelli, F. Xiume', M. Al Refai, M. Salati, R. Marasco, and A. Sabbatini Risk-adjusted morbidity, mortality and failure-to-rescue models for internal provider profiling after major lung resection Interactive CardioVascular and Thoracic Surgery, April 1, 2006; 5(2): 92 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Varela, E. Ballesteros, M. F. Jimenez, N. Novoa, and J. L. Aranda Cost-effectiveness analysis of prophylactic respiratory physiotherapy in pulmonary lobectomy Eur. J. Cardiothorac. Surg., February 1, 2006; 29(2): 216 - 220. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Treasure, C. Tan, L. Lang-Lazdunski, and D. Waller The MARS trial: mesothelioma and radical surgery Interactive CardioVascular and Thoracic Surgery, February 1, 2006; 5(1): 58 - 59. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
