External validation of the European Society of Thoracic Surgeons morbidity and mortality risk models
Author:
Gómez de Antonio David1ORCID, Crowley Carrasco Silvana1, Romero Román Alejandra1, Royuela Ana23ORCID, Gil Barturen Mariana1ORCID, Obiols Carme4, Call Sergi4ORCID, Royo Ínigo5, Recuero José Luis5ORCID, Cabanero Alberto6ORCID, Moreno Nicolás6ORCID, Embún Raúl5ORCID, Bolufer Sergio, Congregado Miguel, Jimenez Marcelo F, Aguinagalde Borja, Amor-Alonso Sergio, Arrarás Miguel Jesús, Orozco Ana Isabel Blanco, Boada Marc, Cal Isabel, Ramos Ángel Cilleruelo, Fernández-Martín Elena, García-Barajas Santiago, García-Jiménez María Dolores, García-Prim Jose María, Garcia-Salcedos José Alberto, Gelbenzu-Zazpe Juan José, Giraldo-Ospina Carlos Fernando, Hernández María Teresa Gómez, Hernández Jorge, Wolf Jennifer D Illana, Abularach Alberto Jáuregui, Jiménez Unai, Sanz Iker López, Martínez-Hernández Néstor J, Martínez-Téllez Elisabeth, Collado Lucía Milla, Poce Roberto Mongil, Moradiellos-Díez Francisco Javier, Moreno-Basalobre Ramón, Merino Sergio B Moreno, Quero-Valenzuela Florencio, Ramírez-Gil María Elena, Ramos-Izquierdo Ricard, Rivo Eduardo, Rodríguez-Fuster Alberto, Rojo-Marcos Rafael, Sanchez-Lorente David, Moreno Laura Sánchez, Simón Carlos, Trujillo-Reyes Juan Carlos, García Cipriano López, Alfara Juan José Fibla, Romero Julio Sesma, Trancho Florentino Hernando,
Affiliation:
1. Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda , Madrid, Spain 2. Unidad de Bioestadística, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA) , Madrid, Spain 3. CIBERESP , Madrid, Spain 4. Servicio de Cirugía Torácica, Hospital Universitari Mútua Terrassa, Universidad de Barcelona , Terrassa, Spain 5. Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón , Zaragoza, Spain 6. Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal , Madrid, Spain
Abstract
Abstract
OBJECTIVES
There is a wide variety of predictive models of postoperative risk, although some of them are specific to thoracic surgery, none of them is widely used. The European Society for Thoracic Surgery has recently updated its models of cardiopulmonary morbidity (Eurolung 1) and 30-day mortality (Eurolung 2) after anatomic lung resection. The aim of our work is to carry out the external validation of both models in a multicentre national database.
METHODS
External validation of Eurolung 1 and Eurolung 2 was evaluated through calibration (calibration plot, Brier score and Hosmer–Lemeshow test) and discrimination [area under receiver operating characteristic curves (AUC ROC)], on a national multicentre database of 2858 patients undergoing anatomic lung resection between 2016 and 2018.
RESULTS
For Eurolung 1, calibration plot showed suboptimal overlapping (slope = 0.921) and a Hosmer–Lemeshow test and Brier score of P = 0.353 and 0.104, respectively. In terms of discrimination, AUC ROC for Eurolung 1 was 0.653 (95% confidence interval, 0.623–0.684). In contrast, Eurolung 2 showed a good calibration (slope = 1.038) and a Hosmer–Lemeshow test and Brier score of P = 0.234 and 0.020, respectively. AUC ROC for Eurolung 2 was 0.760 (95% confidence interval, 0.701–0.819).
CONCLUSIONS
Thirty-day mortality score (Eurolung 2) seems to be transportable to other anatomic lung-resected patients. On the other hand, postoperative cardiopulmonary morbidity score (Eurolung 1) seems not to have sufficient generalizability for new patients.
Funder
Spanish Society of Thoracic Surgery as the best national research project of 2015
Publisher
Oxford University Press (OUP)
Subject
Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,General Medicine,Surgery
Cited by
2 articles.
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