RT Journal Article
SR Electronic
T1 Role of thoracoscore (thoracic surgery scoring system) in clinical practice
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1910
VO 38
IS Suppl 55
A1 Balamugesh Thangakunam
A1 Kanwar Pannu
A1 Kim Wilkins
A1 Basharet Ibrahim
A1 Bernard Yung
A1 Dipak Mukherjee
A1 Doug Aitchison
A1 Johnson Samuel
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/1910.abstract
AB Introduction: Thoracic surgery scoring system (Thoracoscore) a multivariate score with 9 parameters, may predict mortality after thoracic surgery (Lim E. et al. Thorax 2010;65:iii1-iii27). Its role to assess patient fitness for surgery is not clear. Cardiopulmonary exercise test (CPEX) is recommended by ERS to assess fitness for radical therapy in lung cancer patients (Brunelli A. et al. Eur Respir J 2009;34:17-41)Objective: To evaluate role of thoracoscore in patients considered for thoracic surgery.Methods: Retrospective data analysis of patients investigated for thoracic surgery.Results: Over a 2 period, 22 patients with borderline lung function had CPEX to assess for lung resection. Based on CPEX, 15 (68%) were fit and had surgery, 7 (32%) were high risk and turned down. Mean predicted death rate based on thoracoscore in patients who had surgery and those who didn't was 3.5% and 3.4% respectively (p=0.95).Figure 1Interestingly, mean FEV1 in those who had surgery and those who didn't was 59% and 66% respectively (p=0.5). The mean peak VO2 (peak oxygen uptake during CPEX as ml/kg/min) among those who had surgery and those who didn't was 14.2 and 10.1 respectively, with statistically significant difference (p=0.01). There was no post-surgical mortality. Duration of hospital stay did not correlate with peak VO2 or thoracoscore.Conclusion: Thoracoscore has poor correlation with FEV1 and peak VO2 and hence is not reliable to triage patients for thoracic surgery.