Brunelli et al reported two risk models for patients undergoing lung resection surgery. The Eurolung2 score predicts postoperative mortality. The authors are from multiple institutions in Europe.
Patient selection: lung resection surgery
Outcome: 30-day mortality
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) body mass index (BMI)
(7) pneumonectomy
(8) surgical approach (thoracotomy vs VATS)
(9) extended resection
|
Parameter
|
Finding
|
beta-coefficient
|
Aggregate Score
|
|
sex
|
female
|
0
|
0
|
|
|
male
|
0.903
|
3
|
|
age
|
|
0.044*(age)
|
2 if > 65
|
|
CAD
|
absent
|
0
|
0
|
|
|
present
|
0.264
|
1
|
|
CVD
|
absent
|
0
|
0
|
|
|
present
|
0.581
|
2
|
|
ppoFEV1
|
|
-0.009 * (ppoFEV1)
|
1 if < 70%
|
|
BMI
|
no
|
0
|
0
|
|
|
yes
|
-0.064 * (BMI)
|
3 if < 18.5
|
|
pneumonectomy
|
yes
|
0.929
|
3
|
|
|
no
|
0
|
0
|
|
extended resection
|
no
|
0
|
0
|
|
|
yes
|
0.300
|
1
|
|
surgery
|
thoracotomy
|
0.894
|
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 9 parameters) -5.82
probability of morbidity =
= 1/(1+EXP((-1) * X))
aggregate score for morbidity =
= SUM(points for all 9 parameters)
Interpretation:
• minimum aggregate score: 0
• maximum aggregate score: 19
|
Score
|
Morbidity
|
|
0 or 3
|
0.4%
|
|
4 to 6
|
1.4%
|
|
7 or 8
|
2.9%
|
|
9 to 11
|
5%
|
|
12 to 14
|
11%
|
|
15 to 17
|
29%
|
