An original scoring system for predicting postoperative morbidity after esophagectomy for esophageal cancer
An original scoring system for predicting postoperative morbidity after esophagectomy for esophageal cancer
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DOI：
10.1007/s00595-014-0958-5
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发表时间：
2015-03
期刊：
影响因子：
2.5
通讯作者：
N. Yoshida;Y. Baba;Masayuki Watanabe;S. Ida;T. Ishimoto;R. Karashima;S. Iwagami;Y. Imamura;Y. Sakamoto;Y. Miyamoto;H. Baba
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文献类型：
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作者：
N. Yoshida;Y. Baba;Masayuki Watanabe;S. Ida;T. Ishimoto;R. Karashima;S. Iwagami;Y. Imamura;Y. Sakamoto;Y. Miyamoto;H. Baba
目的食管癌切除术后的术后并发症仍然很常见。目前很少有工具可以用来估计并发症的发生率。本研究旨在建立一种新的评分系统来预测术后发病率。方法回顾性分析365例食管癌择期食管切除术合并二野或三野淋巴结切除术的临床资料。患者被分为发展组（n= 250）和验证组（n= 115）。通过指定开发数据集中所有独立预测因子的预期发病率值，建立评分系统，然后在验证数据集中确认其可重复性。结果总发病率为44.7%。男性、严重消瘦（体重指数<18）、较低的工作状态（1级或2级）、手术≥540分钟和大出血（失血量/体重≥20）是术后发病率的独立预测因素。计算所有预测分数的总和。将评分分为≤8、10、11和≥13组后，任何发病和严重发病（Clavien-Dindo分级≥IIIb）的发生率与评分显著相关。这一发现也在验证数据集中得到了证实。结论目前的评分系统可用于预测食管切除术后的并发症。
PurposePostoperative morbidity remains common after esophagectomy. There are currently few tools that can be used to estimate the incidence of complications. This study aimed to create a novel scoring system for predicting postoperative morbidity.MethodsA total of 365 patients who underwent elective esophagectomy with two- or three-field lymphadenectomy for esophageal cancer were retrospectively analyzed. Patients were divided into development (n= 250) and validation datasets (n= 115). A scoring system was established by specifying the expected morbidity incidence values for all independent predictors in the development dataset, after which, the reproducibility was confirmed in the validation dataset.ResultsThe incidence of any morbidity was 44.7 %. Male sex, severe emaciation (body mass index <18), a lower performance status (grade 1 or 2), operation ≥540 min and massive bleeding (blood loss/body weight ≥20) were independent predictors of postoperative morbidity. The total of all predictive scores was calculated. The incidence of any morbidity and of severe morbidity (Clavien–Dindo classification ≥IIIb) significantly correlated with the score after dividing the scores into three groups (≤8, 10 and 11 and ≥13). This finding was also confirmed in the validation dataset.ConclusionThe current scoring system is considered to be useful for predicting postoperative morbidity after esophagectomy.