D'Journo et al reported a model for predicting 90-day mortality for a patient undergoing esophagectomy for cancer. The authors are from multiple institutions from around the world and members of the International Esodata Study Group.
Patient selection: esophagectomy for cancer, not ECOG 4
Parameters:
(1) age in years
(2) body mass index (BMI) in kg per square meter
(3) sex
(4) ECOG performance status
(5) myocardial infarction
(6) connective tissue disease (SLE, RA, etc)
(7) peripheral vascular disease
(8) liver disease, moderate or severe
(9) neoadjuvant therapy
(10) hospital volume for esophagectomies per year
|
Parameter |
Finding |
Points |
|
age |
<= 40 years |
0 |
|
|
41 to 60 years |
1 |
|
|
61 to 80 years |
0 |
|
|
> 80 years |
-3 |
|
BMI |
< 18.5 |
-3 |
|
|
18.5 to 24.9 |
0 |
|
|
>= 25 |
1 |
|
sex |
male |
0 |
|
|
female |
2 |
|
ECOG PS |
0 |
0 |
|
|
1 |
-1 |
|
|
2 |
-2 |
|
|
3 |
-4 |
|
myocardial infarction |
no |
0 |
|
|
yes |
-2 |
|
connective tissue disease |
no |
0 |
|
|
yes |
-3 |
|
peripheral vascular disease |
no |
0 |
|
|
yes |
-2 |
|
liver disease, moderate or severe |
no |
0 |
|
|
yes |
-5 |
|
neoadjuvant therapy |
none |
0 |
|
|
definitive chemoradiation |
-2 |
|
|
chemotherapy only |
0 |
|
|
chemoradiotherapy |
-1 |
|
hospital volume |
<= 108.6 |
0 |
|
|
> 108.6 |
1 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -24
• maximum score: 5
value of X =
= (0.311 * (score)) + 3.382
probability of 90-day mortality =
= 1 / (1 + EXP(X))
|
Total Score |
Risk of 90-Day Mortality |
90-Day Mortality |
|
>= 1 |
very low |
1.8% |
|
0 |
low |
3% |
|
-1 or -2 |
medium |
5.8% |
|
-3 or -4 |
high |
8.9% |
|
<= -5 |
very high |
18.2% |
Performance:
• The area under the ROC curve was 0.68 in the derivation and 0.64 in the validation cohort.
Specialty: Hematology Oncology
