Bartels et al developed a preoperative model for evaluating a patient with resectable esophageal cancer. This can help to identify a patient who may require more aggressive management. The authors are from Universitat Munchen.
Patient selection: resectable esophageal cancer
Outcome: postoperative 30-day mortality
Parameter:
(1) pulmonary function
(2) hepatic function
(3) cardiac function (based on cardiologist's impression)
(4) general status
|
Parameter |
Finding |
Points |
|
pulmonary function |
VC > 90% and PaO2 > 70 mm Hg |
2 |
|
|
compromised |
4 |
|
|
VC <= 90% and PaO2 <= 70 mm Hg |
6 |
|
hepatic function |
normal |
2 |
|
|
compromised |
4 |
|
|
cirrhosis |
6 |
|
cardiac function |
normal risk |
3 |
|
|
compromised |
6 |
|
|
severely impaired and high risk |
9 |
|
general status |
normal (Karnofsky > 80% and good cooperation) |
4 |
|
|
compromised |
8 |
|
|
severely impaired (Karnofsky <= 80% and poor cooperation |
12 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 11
• maximum score: 33
• The higher the score the worse the prognosis.
|
Score |
Risk Group |
Postoperative 30-Day Mortality |
|
11 to 15 |
low |
2% |
|
16 to 21 |
moderate |
5% |
|
22 to 33 |
high |
25% |
Specialty: Anesthesiology
