title: Assessment of a scoring system for predicting complications after esophagectomy.
abstract: Complications occur frequently after esophagectomy. Identifying the risk of complications preoperatively may help in patient selection and postoperative management. We performed a retrospective review of patients who underwent esophagectomy between 1980 and 2009. A previously reported scoring system was used to estimate risk, and its ability to predict complications was assessed. A total of 514 patients (382 men; 74%) with a mean age of 59.0 ± 12.5 years underwent esophagectomy for cancer (398; 77%) or benign disease. Minor complications occurred in 224 patients (44%) and severe complications occurred in 134 patients (26%). The calculated risk score was based on weighted values for age, coronary artery disease, cerebrovascular disease, type of operation, and forced expiratory volume in the first second expressed as a percent of predicted (FEV1%). Increasing risk score was associated with a linear increase in the incidence of complications (P < 0.001 for either severe complications or any complications). The scoring system predicted severe complications with an accuracy of 65.3% (P < 0.001). Score groups identified an incremental risk of severe complications (0 to 6 = 12%; 7 to 13 = 18%; 14 to 20 = 28%; 21 to 27 = 36%; >27 = 52%; P < 0.001). Complications are frequent after esophagectomy and can be predicted using a previously reported scoring system. This scoring system may assist in patient selection for esophagectomy and in providing appropriate resources for postoperative management of higher risk patients.
authors.affiliation: Department of Surgery, The University of Chicago, Chicago, Illinois 60637, USA. mferguso@surgery.bsd.uchicago.edu
authors.forename: M K
authors.initials: MK
authors.lastname: Ferguson
authors.forename: A D
authors.initials: AD
authors.lastname: Celauro
authors.forename: V
authors.initials: V
authors.lastname: Prachand
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment