Universität zu Köln

Fuchs, H. F., Harnsberger, C. R., Broderick, R. C., Chang, D. C., Sandler, B. J., Jacobsen, G. R., Bouvet, M. and Horgan, S. (2017). Simple preoperative risk scale accurately predicts perioperative mortality following esophagectomy for malignancy following esophagectomy for malignancy. Dis. Esophagus, 30 (1). CARY: OXFORD UNIV PRESS INC. ISSN 1442-2050

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Abstract

Surgery remains one of the major treatment options available to patients with esophageal cancer, with high mortality in certain cohorts. The aim of this study was to develop a simple preoperative risk scale based on patient factors, hospital factors, and tumor pathology to predict the risk of perioperative mortality following esophagectomy for malignancy. The Nationwide Inpatient Sample database was used to create the risk scale. Patients who underwent open or laparoscopic transhiatal and transthoracic esophageal resection were identified using International Classification of Diseases, 9th edition codes. Patients < 18 years and those with peritoneal disease were excluded. Multivariate logistic regressions were used to define a predictive model of perioperative mortality and to create a simple risk scale. From 1998 to 2011, a total of 23 751 patients underwent esophagectomy. The observed overall perioperative mortality rate for this cohort was 7.7%. Minimally invasive techniques, and operations performed in higher volume centers were protective, whereas increasing age, comorbidities and diagnosis of squamous cell carcinoma were independent predictors of mortality. Based on this population, a risk scale from 0-16 was created. The calibration revealed a good agreement between the observed and risk scale-predicted probabilities. A set of sensitivity/specificity analyses was then performed to define normal (score 0-7) and high risk (score 8-16) patients for clinical practice. Mortality in patients with a score of 0-7 ranged from 1.3-7.6%, compared with 10.5-34.5% in patients with a score of 8-16. This simple preoperative risk scale may accurately predict the risk of perioperative mortality following esophagectomy for malignancy and can be used as a clinical tool for preoperative counseling.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fuchs, H. F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Harnsberger, C. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Broderick, R. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chang, D. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sandler, B. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jacobsen, G. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bouvet, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Horgan, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-243240
DOI:	10.1111/dote.12451
Journal or Publication Title:	Dis. Esophagus
Volume:	30
Number:	1
Date:	2017
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1442-2050
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SQUAMOUS-CELL CARCINOMA; HIGH-VOLUME CENTERS; ADMINISTRATIVE DATABASES; NEOADJUVANT CHEMORADIATION; TRANSHIATAL ESOPHAGECTOMY; POSTOPERATIVE MORTALITY; CANCER; OUTCOMES; RESECTION; ESOPHAGUS Multiple languages Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24324