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Performance Comparison of Pulmonary Risk Scoring Systems in Lung Resection
Andres Zorrilla-Vaca1, Michael C Grant2, Muhammad Rehman3
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Anesthesiology, Universidad del Valle, Hospital Universidad del Valle, Cali, Colombia.
Journal of Cardiothoracic and Vascular Anesthesia
|June 17, 2023
Summary
Existing pulmonary risk scores show poor accuracy in predicting postoperative pulmonary complications (PPCs) after lung resection. New risk assessment tools are needed for better patient risk stratification in thoracic surgery.
Area of Science:
- Thoracic Surgery
- Anesthesiology
- Pulmonary Medicine
Background:
- Postoperative pulmonary complications (PPCs) are a significant concern following lung resection surgery.
- Accurate prediction of PPCs is crucial for patient management and optimizing surgical outcomes.
Purpose of the Study:
- To validate and compare the performance of existing pulmonary risk scoring systems in predicting PPCs after lung resection.
- To assess the impact of incorporating predicted postoperative forced expiratory volume (ppoFEV1) on the accuracy of these scores.
Main Methods:
- Retrospective cohort study of adult patients undergoing lung resection surgery.
- Evaluation of ARISCAT, LAS VEGAS, SPORC, and CARDOT scoring systems for predicting PPCs.
- Assessment of discrimination (c-index) and calibration (intercept) of scoring systems, with and without ppoFEV1.
Main Results:
- All evaluated scoring systems demonstrated poor discriminatory power for predicting PPCs.
- The inclusion of ppoFEV1 marginally improved the performance of the LAS VEGAS and CARDOT scores.
- Calibration analysis indicated a slight overestimation of risk by the ARISCAT and LAS VEGAS systems.
Conclusions:
- Current pulmonary risk scoring systems lack adequate discriminatory power for predicting PPCs in lung resection patients.
- Development of novel risk assessment tools is necessary for improved prediction of PPCs in thoracic surgery.
