Risk Score of Foster et al for Pulmonary Complications After Esophagectomy

Description

Foster et al reported a score for predicting the risk of pulmonary complications after a esophagectomy. This can help to identify a patient who may benefit from more aggressive management. The authors are from Virginia Commonwealth University and the University of Virginia.

Patient selection: esophagectomy

Outcome: 30-day risk of unplanned reintubation, postoperative pneumonia, failure to liberate from mechanical ventilation within 48 hours of being intubated

Parameters:

(1) age in years

(2) ASA class

(3) history of severe COPD

(4) smoking status

(5) dyspnea

(6) functional dependency

(7) total operation time in minutes

(8) preoperative serum creatinine in mg/dL

Parameter	Finding	Points
age	< 60 years	0
	60 to 69 years	10
	70 to 79 years	37
	>= 80 years	49
ASA class	I or II	0
	III, IV or V	32
history of severe COPD	no	0
	yes	58
smoking status	current or within past year	34
	stopped > 1 year	0
	never	0
dyspnea	none or mild	0
	moderate or at rest	35
functional dependency	none	0
	partial or total	79
operation time	< 248 minutes	0
	248 to 335 minutes	20
	336 to 434 minutes	26
	>= 435	56
preoperative creatinine	<= 1.2 mg/dL	0
	> 1.2 mg/dL	30

total score =

= SUM(points for all 8 parameters)

Interpretation:

• minimum score: 0

• maximum score: 373

• The higher the score the greater the risk of postoperative pulmonary complications.

Score	Pulmonary Complications
< 57	10.8-11.7%
57 to 83	17.2-19.4%
84 to 116	22.3-25.2%
> 116	37.2-37.6%

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Risk Score of Foster et al for Pulmonary Complications After Esophagectomy

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