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E. Belcher



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    P1.07 - Poster Session 1 - Surgery (ID 184)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P1.07-020 - Thoracoscore and European Society Objective Score Do Not Predict Mortality in The UK Population - Is It Time For a New Risk Model? (ID 1459)

      09:30 - 09:30  |  Author(s): E. Belcher

      • Abstract

      Background
      Thoracoscore and the European Society Objective Score (ESOS.01) are two risk scoring systems used to estimate risk of death as part of informed consent, and to allow risk adjusted outcomes to be evaluated. We aimed to evaluate if these are valid tools for use in the United Kingdom (UK) population.

      Methods
      A multi-centre, prospective study was carried out on patients undergoing lung resection at 6 UK centres. Data were submitted electronically using our online data collection tool. Univariate and multivariate analyses were carried out to determine the factors affecting mortality. A Receiver Operating Characteristic (ROC) analysis was performed in order to determine the ability of the Thoracoscore and ESOS.01 to predict in-hospital mortality.

      Results
      Data were submitted for 2570 patients. 345 patients were excluded due to incomplete data fields. Of the remaining 2245 patients, the observed in-hospital mortality was 31 patients (1.38%). Mean Thoracoscore was 2.66(SD±3.21). Logistic regression analysis identified gender (p=0.004, hazard ratio 4.786) and co-morbidity score (p=0.005, hazard ratio 3.289) as risk factors for mortality. A sub-analysis was performed using data from 1912 patients. In this group, mean Thoracoscore was 2.55(SD±2.94), mean ESOS.01 was 2.11(SD±1.41), and these were statistically significantly different (p<0.0001). The observed in-hospital mortality was 28 patients (1.46%). The c-index for Thoracoscore was 0.705, and for ESOS.01, 0.739. Furthermore, there was poor correlation between the two scoring systems (r=0.362).

      Conclusion
      Both Thoracoscore and ESOS.01 overestimated mortality in the UK population. There is a continued need to develop an appropriate risk prediction system for the UK.