Brunelli et al reported two risk models for patients undergoing lung resection surgery. The Eurolung1 score predicts postoperative morbidity. The authors are from multiple institutions in Europe.
Patient selection: lung resection surgery
Outcome: cardiopulmonary morbidity
Parameters:
(1) sex
(2) age in years
(3) coronary artery disease (CAD)
(4) cerebrovascular disease (CVD)
(5) predicted postoperative FEV1 (ppoFEV1) in percent based on number of segments resected
(6) chronic kidney disease (CKD)
(7) extended resection
(8) surgical method (thoracotomy versus video-assisted thoracoscopic surgery (VATS)
|
Parameter
|
Finding
|
beta-coefficient
|
Aggregate Score
|
|
sex
|
female
|
0
|
0
|
|
|
male
|
0.497
|
3
|
|
age
|
|
0.026*(age)
|
3 if > 65
|
|
CAD
|
absent
|
0
|
0
|
|
|
present
|
0.231
|
2
|
|
CVD
|
absent
|
0
|
0
|
|
|
present
|
0.371
|
2
|
|
CKD
|
absent
|
0
|
0
|
|
|
present
|
0.152
|
1
|
|
ppoFEV1
|
|
-0.015 * (ppoFEV1)
|
3 if < 70%
|
|
extended resection
|
no
|
0
|
0
|
|
|
yes
|
0.514
|
3
|
|
surgical method
|
thoracotomy
|
0.497
|
3
|
|
|
VATS
|
0
|
0
|
where:
• The ppoFEV1 is presumed to be based on the percent loss of preoperative FEV1 due to loss of respiratory tissue.
X =
= SUM(beta-coefficients for all 8 parameters) -2.465
probability of morbidity =
= 1/(1+EXP((-1) * X))
aggregate score for morbidity =
= SUM(points for all 8 parameters)
Interpretation:
• minimum aggregate score: 0
• maximum aggregate score: 20 (19 in paper)
|
Score
|
Morbidity
|
|
0 or 1
|
5%
|
|
2 to 4
|
8%
|
|
5 to 7
|
14%
|
|
8 to 11
|
22%
|
|
12 to 16
|
32%
|
|
17 to 19
|
43%
|
