Heiden et al reported the VA Lung Cancer Mortality (VALCAN-M) score, which is predictive of 90-day mortality. The authors are from the VA St. Louis Health Care System, Washington University and Saint Louis University.
Patient selection: stage I lung cancer
Parameters:
(1) age in years
(2) body mass index (BMI) in kg per square meter
(3) FEV1 as percent of predicted
(4) extent of resection
(5) surgical approach
(6) histologic diagnosis
(7) number of weeks after radiographic diagnosis
(8) history of congestive heart failure (CHF)
(9) functional status
(10) history of peripheral vascular disease (PVD)
(11) ASA status
|
Parameter |
Finding |
Points |
|
age in years |
< 60 years |
-4 |
|
|
60 to 69 years |
0 |
|
|
70 to 79 years |
3 |
|
|
>= 80 years |
5 |
|
body mass index |
< 18.5 |
6 |
|
|
18.5 to 24.9 |
0 |
|
|
25 to 34.9 |
-1 |
|
|
>= 35 |
0 |
|
FEV1 |
>= 80% |
0 |
|
|
60 to 79% |
1 |
|
|
< 60% |
2 |
|
extent of resection |
wedge |
-2 |
|
|
segmentectomy |
-2 |
|
|
lobectomy |
0 |
|
|
pneumonectomy |
8 |
|
surgical approach |
open |
0 |
|
|
minimally invasive |
-3 |
|
histologic diagnosis |
adenocarcinoma |
0 |
|
|
squamous cell |
2 |
|
|
other |
1 |
|
weeks for Xray diagnosis |
<= 12 weeks |
0 |
|
|
> 12 weeks (delayed therapy) |
3 |
|
history of CHF |
no |
0 |
|
|
yes |
2 |
|
functional status |
independent |
0 |
|
|
partially dependent |
6 |
|
|
fully dependent |
6 |
|
history of PVF |
no |
0 |
|
|
yes |
2 |
|
ASA status |
ASA 1 |
0 |
|
|
ASA 2 |
2 |
|
|
ASA 3 |
3 |
|
|
ASA 4 |
4 |
|
|
ASA 5 |
5 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -10
• maximum score: 42
• The higher the score the greater the 90-day mortality.
|
Total Score |
Risk Group |
90-Day Mortality |
|
-10 to -1 |
very low |
< 1% |
|
0 to 6 |
low |
1-4% |
|
7 to 11 |
moderate |
4-10% |
|
>= 12 |
high |
> 10% |
Performance:
• The area under the ROC curve is 0.74.
Specialty: Hematology Oncology
