Zorbas et al reported a score for predicting mortality following lung decortication. This can help to identify a patient who may require more aggressive management. The authors are from Indiana University, Brown University, Mount Sinai Health System, Bronx Care Hospital, Henry Dunant Hospital Center (Athens), and NYC Health.
Patient selection: status post lung decortication
Outcome: 30-day postoperative mortality
Parameters:
(1) age in years
(2) preoperative dyspnea
(3) ventilator dependent
(4) history of COPD
(5) congestive heart failure
(6) currently on dialysis
(7) disseminated cancer
(8) open wound or wound infection
(9) transfusion of packed red blood cells
(10) sepsis within 48 hours prior to surgery
(11) functional status
Parameter
Finding
Points
age in years
< 65 years
0
>= 65 years
1
preoperative dyspnea
no
0
yes
1
ventilator dependent
no
0
yes
1
history of COPD
no
0
yes
1
congestive heart failure
no
0
yes
1
currently on dialysis
no
0
yes
1
disseminated cancer
no
0
yes
1
open round or wound infection
no
0
yes
1
transfusion RBCs
no
0
yes
1
sepsis in 48 hours before
no
0
yes
1
functional status
independent
0
dependent
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
Score
Unadjusted OR
Mortality
0
1
0.6%
1
2
1.1%
2 or 3
12.5
6.6%
>= 4
65.8
27.1%
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