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J Thorac Cardiovasc Surg 2007;134:883-887
© 2007 The American Association for Thoracic Surgery

General Thoracic Surgery

Thoracoscore predicts midterm mortality in patients undergoing thoracic surgery

Themistocles P. Chamogeorgakis, MDa,*, Cliff P. Connery, MDb, Faiz Bhora, MDb, Andy Nabong, MAb, Ioannis K. Toumpoulis, MDa

a Department of Cardiothoracic Surgery, University of Athens School of Medicine, Attikon Hospital Center, Athens, Greece
b College of Physicians and Surgeons of Columbia University, Department of Cardiothoracic Surgery, St Luke’s–Roosevelt Hospital Center, New York, NY.

Received for publication February 19, 2007; revisions received June 9, 2007; accepted for publication June 21, 2007.

* Address for reprints: Themistocles P. Chamogeorgakis, MD, Sofokleous 36, Voula, 16673, Greece. (Email: thchamogeorgakis{at}yahoo.com).

Objective: Thoracoscore is the first multivariate model for the prediction of in-hospital mortality after general thoracic surgery. We aimed to evaluate the performance of Thoracoscore in predicting in-hospital and midterm all-cause mortality.

Methods: We retrospectively evaluated 1675 patients who underwent thoracic surgery (lung resections [n = 626], mediastinum [n = 535], pleura and pericardium [n = 268], esophagus [n = 88], chest wall [n = 90], trachea [n = 45], and other procedures [n = 23]) from October 2002 to March 2006 at a single institution. Midterm survival data (mean follow-up 25 ± 16 months) were obtained from the National Death Index. Kaplan–Meier survival plots of the quartiles of Thoracoscore were constructed and compared with the log–rank test with adjustment for trend.

Results: Starting from the lower-risk to the higher-risk quartile, the in-hospital mortality rates were 0% (0/418), 1% (4/415), 2.5% (11/435), and 9.6% (54/407). Thoracoscore was a strong independent predictor for in-hospital mortality (odds ratio 1.20, 95% confidence intervals 1.15-.25; P < .001). The 2-year survivals of the Thoracoscore quartiles were 98.7% ± 0.6%, 87.0% ± 1.8%, 73.8% ± 2.3%, and 54.8% ± 2.7%, respectively (P < .0001). Thoracoscore was a strong independent predictor for midterm mortality (hazard ratio 1.12, 95% confidence intervals 1.11-1.14; P < .001).

Conclusion: Thoracoscore is a good and useful clinical tool for preoperative prediction of in-hospital and midterm mortality among patients undergoing general thoracic surgery.

Abbreviation and Acronym CI = confidence interval






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