Subject(s)
Colonic Pseudo-Obstruction/diagnosis , Hypothyroidism/complications , Acute Disease , Aged, 80 and over , Cholinesterase Inhibitors/therapeutic use , Colonic Pseudo-Obstruction/complications , Colonic Pseudo-Obstruction/diagnostic imaging , Colonic Pseudo-Obstruction/drug therapy , Colonic Pseudo-Obstruction/surgery , Colonic Pseudo-Obstruction/therapy , Diagnosis, Differential , Humans , Laparotomy , Male , Neostigmine/therapeutic use , Parasympatholytics/therapeutic use , Radiography, Abdominal , Radiography, Thoracic , Treatment OutcomeABSTRACT
BACKGROUND: Different prediction models for operative mortality after esophagectomy have been developed. The aim of this study is to independently validate prediction models from Philadelphia, Rotterdam, Munich, and the ASA. METHODS: The scores were validated using logistic regression models in two cohorts of patients undergoing esophagectomy for cancer from Switzerland (n = 170) and Australia (n = 176). RESULTS: All scores except ASA were significantly higher in the Australian cohort. There was no significant difference in 30-day mortality or in-hospital death between groups. The Philadelphia and Rotterdam scores had a significant predictive value for 30-day mortality (p = 0.001) and in-hospital death (p = 0.003) in the pooled cohort, but only the Philadelphia score had a significant prediction value for 30-day mortality in both cohorts. Neither score showed any predictive value for in-hospital death in Australians but were highly significant in the Swiss cohort. ASA showed only a significant predictive value for 30-day mortality in the Swiss. For in-hospital death, ASA was a significant predictor in the pooled and Swiss cohorts. The Munich score did not have any significant predictive value whatsoever. CONCLUSION: None of the scores can be applied generally. A better overall predictive score or specific prediction scores for each country should be developed.