External validation of the modified Thoracoscore in a new thoracic surgery program: prediction of in-hospital mortality.
Interact Cardiovasc Thorac Surg
; 9(3): 463-6, 2009 Sep.
Article
em En
| MEDLINE
| ID: mdl-19549645
ABSTRACT
Informed consent prior to any surgical intervention should include in-hospital survival estimation after the procedure performed. The recently developed Thoracoscore predicts well the postoperative mortality possibility. The purpose of our study was to test the modified Thoracoscore performance in our new thoracic program. One hundred and fifty-five consecutive patients underwent thoracic surgery procedure within two years. The procedures performed were 62 lung resections, 10 open tumor biopsies, 21 neck and mediastinal procedures, 33 chest wall and pleural procedures, 8 tracheal procedures, 3 esophageal procedures, 13 minor cardiac procedures, and 5 chest trauma cases. The modified Thoracoscore was calculated based on the following variables age, gender, priority of the procedure, malignancy, type of procedure, Zubrod score, ASA class, and number of co-morbidities. The observed mortality was 5.2% (eight deaths) while the predicted one based on the modified Thoracoscore was 4.9%. The scoring system we used had excellent discriminatory ability with a C statistic (0.95, 95% CIs 0.91-0.99). The Hosmer-Lemeshow goodness-of-fit was not statistically significant (P=0.82), indicating acceptable calibration of the model for the present series. The modified Thoracoscore's ability to predict postoperative survival in the whole context of thoracic surgery performs well in our program. Application of any risk scoring system requires external validation and provides comparison of the actual outcomes with other programs.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Avaliação de Processos e Resultados em Cuidados de Saúde
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Indicadores Básicos de Saúde
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Procedimentos Cirúrgicos Torácicos
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Hospitais Universitários
Tipo de estudo:
Etiology_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
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Implementation_research
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Patient_preference
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Interact Cardiovasc Thorac Surg
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Grécia