| Objective To study the risk assessment system of European Cardiac Surgery (EuroScoreⅡ)’s application in thoracic surgery, and to update a better risk assessment model for thoracic surgery (hereinafter referred toas a-EuroScoreⅡ). Finally, to evaluate the a-EuroScoreⅡ for the mortality of the thoracic surgery.Methods We collected prospective risk and outcome data on 727 consecutive patients undergoing major thoracic surgery over a 32-month period (January 2010-August 2013).And one part of the data were a developmental data set (545 patients) using random sampling from a binomial distribution with a probability 0.25. The developmental data set is used to identify variables that were associated with mortality and update a-EuroScoreⅡ model for patients with thoracic surgery. It is used to predict the mortality and complication of 727patients with thoracic surgery:the correlation of the predictive mortality and the actual mortality.Outcome There are 727 medical records, included 166 patients with Esophageal surgery,60 patients with Mediastinal surgery,7 patients with Pneumonectomy,359 patients with lobectomy of lung,135 patients with wedge resection of the Lung. Esophageal surgery and lobectomy of lung are the risk factor for mortality and the differences are obviously. So one is assigned a 0-coefficient of 0.65, and another is 0.55. In total, the real mortality is 1.93%(14 /727),the rate of postoperative complication is 4.13%(30/727). The predictive result of a-EuroScoreⅡ is that the mortality is 1.2%, Hosmer—Lemeshow X2: 9.223、14.254,(P>0.05);Area of ROC:0.742、0.724,(P<0.05).Conclusion Esophageal surgery and lobectomy of lung can be an independent risk factor of the EuroScoreⅡ of the adjusted thoracic surgery. The results of mortality and the incidence of complications are lower than the actual, but the a-EuroscoreⅡ model of conformity degree and accuracy is good. So it can predict the risk of the thoracic surgery well. |
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