Thoracoscore predicts midterm mortality in patients undergoing thoracic surgery.
OBJECTIVE
Thoracoscore is the first multivariate model for the prediction of in-hospital mortality after general thoracic surgery. We aimed to evaluate the performance of Thoracoscore in predicting in-hospital and midterm all-cause mortality.


METHODS
We retrospectively evaluated 1675 patients who underwent thoracic surgery (lung resections [n = 626], mediastinum [n = 535], pleura and pericardium [n = 268], esophagus [n = 88], chest wall [n = 90], trachea [n = 45], and other procedures [n = 23]) from October 2002 to March 2006 at a single institution. Midterm survival data (mean follow-up 25 +/- 16 months) were obtained from the National Death Index. Kaplan-Meier survival plots of the quartiles of Thoracoscore were constructed and compared with the log-rank test with adjustment for trend.


RESULTS
Starting from the lower-risk to the higher-risk quartile, the in-hospital mortality rates were 0% (0/418), 1% (4/415), 2.5% (11/435), and 9.6% (54/407). Thoracoscore was a strong independent predictor for in-hospital mortality (odds ratio 1.20, 95% confidence intervals 1.15-.25; P < .001). The 2-year survivals of the Thoracoscore quartiles were 98.7% +/- 0.6%, 87.0% +/- 1.8%, 73.8% +/- 2.3%, and 54.8% +/- 2.7%, respectively (P < .0001). Thoracoscore was a strong independent predictor for midterm mortality (hazard ratio 1.12, 95% confidence intervals 1.11-1.14; P < .001).


CONCLUSIONS
Thoracoscore is a good and useful clinical tool for preoperative prediction of in-hospital and midterm mortality among patients undergoing general thoracic surgery.
Chamogeorgakis
Themistocles P
TP
Department of Cardiothoracic Surgery, University of Athens School of Medicine, Attikon Hospital Center, Athens, Greece. thchamogeorgakis@yahoo.com
Connery
Cliff P
CP
Bhora
Faiz
F
Nabong
Andy
A
Toumpoulis
Ioannis K
IK
D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008171:Lung Diseases / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D019616:Thoracic Surgical Procedures / Q000379:methods / Q000401:mortality*