Independent predictors for early and midterm mortality after thoracic surgery.

Area of Science:

• Thoracic Surgery
• Surgical Outcomes
• Mortality Prediction

Background:

• Thoracic surgery encompasses a wide range of procedures including lung, mediastinal, pleural, pericardial, esophageal, and chest wall operations.
• Assessing patient outcomes and identifying mortality predictors are crucial for improving surgical care.

Purpose of the Study:

• To determine independent predictors for both early (in-hospital) and midterm mortality following thoracic surgery.
• To provide data for risk stratification and enhanced patient management in thoracic surgical procedures.

Main Methods:

• A cohort of 1453 consecutive patients undergoing thoracic surgery between 2002 and 2005 was analyzed.
• In-hospital mortality was assessed using multivariate logistic regression.
• Midterm mortality was evaluated using multivariate Cox regression analysis with data from the National Death Index (mean follow-up 2.0 years).

Main Results:

• In-hospital mortality (3.2%) predictors included higher Zubrod and ASA scores, and pneumonectomy.
• Midterm mortality (21.5%) predictors were diverse, including age, weight loss, higher Zubrod and ASA scores, primary lung cancer, extrapulmonary metastases, and postoperative complications.
• Protective factors for midterm mortality included a history of cerebrovascular events, primary chest wall tumors, and absence of comorbidities.

Conclusions:

• Independent predictors for in-hospital and midterm mortality in thoracic surgery were identified.
• Zubrod and ASA scores are significant independent predictors affecting both early and midterm mortality in thoracic surgery patients.