Scores of Ballian et al for Morbidity and Mortality Following Surgical Repair of a Giant Paraesophageal Hernia

Description

Ballian et al developed scores for evaluating patients undergoing surgical repair of a giant paraesophageal hernia. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Pittsburgh.

Patient selection: laparoscopic repair of a giant paraesophageal hernia

Parameters:

(1) age in years

(2) congestive heart failure

(3) pulmonary disease

(4) type of surgery

(5) gender

Parameter	Finding	Points for Mortality
age of the patient	< 80 years	0
	>= 80 years	9
congestive heart failure	absent	0
	present	5
pulmonary disease	absent	0
	present	3
surgery type	urgent or emergent	3
	elective	0

score for mortality =

= SUM(points for all 4 parameters)

Parameter	Finding	Points for Morbidity
gender of the patient	femael	0
	male	1
age of the patient	< 50 years	0
	50 to 59 years	1
	60 to 79 years	2
	>= 80 years	3
congestive heart failure	absent	0
	present	4
pulmonary disease	absent	0
	present	2
surgery type	urgent or emergent	2
	elective	0

score for morbidity = =

= SUM(points for all 5 parameters)

Interpretation:

• minimum morbidity and mortality scores: 0

• maximum mortality score: 20

• maximum morbidity score: 12

• The higher the scores the greater the risk.

Score for Mortality	Risk Group	Mortality
0 to 2	low	0.2%
3	intermediate	0.7%
4 to 20	high	9.3%

Score for Morbidity	Risk Group	>= 1 Major Adverse Event
0 to 2	minimal	14%
3	low	20%
4	intermediate	26%
5 to 12	high	41%

Performance:

• The area under the ROC curve for morbidity was 0.68.

• The discriminatory accuracy for mortality was 88%.

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Scores of Ballian et al for Morbidity and Mortality Following Surgical Repair of a Giant Paraesophageal Hernia

Description

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