Patient selection: prior to adrenalectomy, age >= 18 years
Outcome: 90-day postoperative mortality
Parameters:
(1) age in years
(2) chronic obstructive lung disease (COPD)
(3) diabetes
(4) congestive heart failure
(5) peripheral vascular disease
(6) cerebrovascular disease
(7) moderate or severe liver disease
(8) tumor hormone secretion
(9) suspicion of malignancy
|
Parameter
|
Finding
|
Points
|
|
age in years
|
18 to 49
|
0
|
|
|
50 to 74
|
8
|
|
|
>= 75
|
17
|
|
COPD
|
no
|
0
|
|
|
yes
|
4
|
|
diabetes
|
no
|
0
|
|
|
yes
|
4
|
|
congestive heart failure
|
no
|
0
|
|
|
yes
|
8
|
|
peripheral vascular disease
|
no
|
0
|
|
|
yes
|
8
|
|
cerebrovascular disease
|
no
|
0
|
|
|
yes
|
16
|
|
moderate or severe liver disease
|
no
|
0
|
|
|
yes
|
28
|
|
hormone secretion
|
no
|
4
|
|
|
yes
|
0
|
|
suspect malignancy
|
no
|
0
|
|
|
yes
|
13
|
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: 0
• maximum score: 102 (Figure 2 indicates 100)
• The greater the score the greater the mortality rate.
• Mortality is higher in a low-volume center (< 32 cases per year) than in a high-volume center.
• A score < 20 indicates low-risk and a score >= 20 indicates high-risk.
• A patient determined to be at high risk should be treated at a high-volume center.
Performance:
• The area under the ROC curve is 0.82.
