Reeh et al reported the Preoperative Esophagectomy Risk (PER) score to evaluate a patient with esophageal cancer prior to surgical resection. This can help to identify a patient at risk for postoperative complications. The authors are from University Medical Centre Hamburg-Eppendorf, University Hospital Schleswig-Holstein and University of Lubeck.
Patient selection: esophageal cancer, prior to surgical resection
Outcome: short and long term morbidity and mortality
Parameters:
(1) revised cardiac risk index (RCRI)
(2) MELD score (modified)
(3) pulmonary function tests (vital capacity and FEV1 as percent of predicted)
|
Parameter |
Finding |
Points |
|
RCRI |
0 |
0 |
|
|
1 |
1 |
|
|
2 |
2 |
|
|
>= 3 |
3 |
|
MELD score |
< 6.43 |
0 |
|
|
6.43 to 8.00 |
1 |
|
|
> 8 |
2 |
|
Vital Capacity |
FEV1 |
Points |
|
> 80% (0) |
> 80% (0) |
1 |
|
> 80% (0) |
60.01 to 80% (1) |
1 |
|
60.01 to 80% (1) |
> 80% (0) |
1 |
|
60.01 to 80% (1) |
60.01 to 80% (1) |
2 |
|
> 80% (0) |
<= 60% (2) |
2 |
|
<= 60% (2) |
> 80% (0) |
2 |
|
<= 60% (2) |
<= 60% (2) |
3 |
|
60.01 to 80% (1) |
<= 60% (2) |
3 |
|
< 60% (2) |
60.01 to 80% (1) |
3 |
where:
• A VC > 80% and FEV1 > 80% of predicted indicates normal lung function. It is unclear why this is not scored 0.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum total score: 1
• maximum total score: 8
• The interpretation at this point may have been lost in translation. This is because risk is given by total score and number of organ impairments (presumably indicated by a score of 2 or 3 points),
|
Score |
Organ Impairment |
Risk Group |
|
0 to 3 |
none |
low (1) |
|
4 |
1 |
intermediate (2) |
|
5 to 8 |
2 or more |
high (3) |
Specialty: Anesthesiology
