Simons et al developed a simple score for predicting perioperative mortality for a patient undergoing resection of a hepatic neoplasm. This can help to identify a patient who may be at greater risk for surgery. The authors are from the University of Massachusetts.
Patient selection: resection of a hepatic neoplasm (primary or metastatic), excluding transplant, apparently adults
Parameters:
(1) gender
(2) age in years
(3) Romano modification of the Charlson comorbidity score
(4) procedure type (radiofrequency ablation or RFA, enucleation, wedge resection, lobectomy)
(5) hospital type
(6) hepatic neoplasm type
Parameter |
Finding |
Points |
gender |
male |
1 |
|
female |
0 |
age in years |
<= 55 years |
0 |
|
56 to 65 years |
1 |
|
66 to 75 years |
2 |
|
> 75 years |
5 |
comorbidity score |
0 |
0 |
|
1 |
2 |
|
2 |
4 |
|
>= 3 |
9 |
procedure type |
RFA/enucleation |
0 |
|
wedge resection |
3 |
|
lobectomy |
6 |
hospital type |
teaching |
0 |
|
nonteaching |
1 |
neoplasm type |
primary |
2 |
|
metastatic |
0 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• The higher the score the greater the perioperative mortality.
Total Score |
Mortality (rounded) |
0 to 4 |
1% |
5 to 9 |
2.5% |
10 to 14 |
7% |
15 to 19 |
18% |
20 to 24 |
36% |
Performance:
• The area under the ROC curve was 0.76 for the derivation set and 0.70 for the validation set.
Specialty: Gastroenterology, Surgery, general, Surgery, orthopedic