Froehner et al developed an index to predict competing mortality for a patient prior to radical cystectomy or prostatectomy. This can help to identify a patient who may or may not benefit from aggressive management. The authors are from University Hospital Carl Gustav Carus in Dresden, Germany.
Patient selection: candidate for radical prostatectomy (male) or radical cystectomy (male, female)
Parameters:
(1) age in years
(2) angina class by the Canadian Cardiovascular Soceity Functional Classification (CCS)
(3) chronic lung disease
(4) diabetes mellitus
(5) current smoker
(6) ASA class
Parameter
Finding
Points
age in years
< 50
0
50 to 59 years
1
60 to 69 years
2
70 to 79 years
3
80 to 89 years
4
>= 90 years
5
angina
none or CCS 1
0
CCS 2 to 4
1
chronic lung disease
absent
0
present
1
diabetes mellitus
absent
0
present
1
current smoker
no
0
yes
1
ASA class
1 or 2
0
3 to 5
1
index =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the mortality.
Score
10 Year Competing Mortality
0
0%
1
3%
2
7%
3
13-14%
4
20-28%
5
37-48%
6
44%
7
50%
8 to 10
too few
approximated from Table 5.
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