Risk Score Devised for Esophagectomy Survival

Age, comorbidity, hospital volume all predictive characteristics

THURSDAY, Sept. 14 (HealthDay News) -- A simple risk score can broadly predict surgical mortality after esophagectomy, based on clinical characteristics and hospital volume, according to a study in the Sept. 10 issue of the Journal of Clinical Oncology.

Ewout W. Steyerberg, Ph.D., of University Medical Center Rotterdam in the Netherlands, and colleagues analyzed data on four cohorts of patients. Data from one cohort of 1,327 patients drawn from the Surveillance, Epidemiology and End Results (SEER) - Medicare database was used to predict mortality within 30 days of surgery. The score chart was then developed and tested on three other cohorts, one from the SEER-Medicare database and two from a population-based registry and a referral hospital in the Netherlands.

Among the four cohorts, surgical mortality ranged from four percent to 11 percent. Among the factors predictive of surgical mortality were age; comorbidity due to cardiac, pulmonary, renal and hepatic causes as well as diabetes; preoperative radiotherapy or combined chemo-radiotherapy; and a relatively low hospital volume of cases. The score worked well to predict risk of mortality but had relatively low powers of discrimination.

"Surgical mortality after esophagectomy is an important quality of care measure, but it is only predictable to a certain extent with a limited set of patient, treatment and hospital characteristics," the authors concluded.

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