Ballian et al developed clinical prediction rules for a patient undergoing laparoscopic repair of a giant paraesophageal hernia. One model predicts short-term mortality. The authors are from the University of Pittsburgh.
Patient selection: laparoscopic repair of a giant paraesophageal hernia
Outcome: mortality, in-hospital or within 30 days
Parameters:
(1) congestive heart failure
(2) pulmonary disease
(3) surgical acuity
(4) age of the patient in years
Parameter
Finding
Points
congestive heart failure
absent
0
present
5
pulmonary disease
absent
0
present
3
surgical acuity
elective
0
nonelective
3
age of the patient
< 80 years
0
>= 80 years
9
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the greater the mortality.
Total Score
Risk Group
Mortality
0 to 2
low
0.2%
3
intermediate
0.7%
>= 4
high
9.3%
Performance:
• The area under the ROC curve was 0.88.
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