Surgical risk score as a useful predictor for postoperative complications in lung cancer patients

Abstract

The estimation of physiological ability and surgical stress (E-PASS) is one proposed evaluation system for postoperative morbidity and mortality. Although less invasive video-assisted thoracic surgery (VATS) is widely used as a surgical approach for lung cancer, prediction of postoperative complications is still unclear. In this study, we validate the utility of modified E-PASS (mE-PASS), using the comprehensive risk score fixed (CRSf) that has been designed and specialized for complete-VATS (c-VATS). A total of 444 eligible patients who underwent c-VATS lobectomy for lung cancer were retrospectively analyzed. They were divided into two groups: the CRSf-high (n=175) and CRSf-low (n=269) groups. The cutoff value for the CRSf was obtained using receiver operating characteristic curve analysis. We calculated the mE-PASS scores and evaluated the correlation between the CRSf and the occurrence of postoperative pulmonary and cardiac complications (PCCs) in the two groups. The occurrence of PCCs was significantly higher in the CRSf-high group. Logistic regression analysis demonstrated that the mE-PASS CRSf score was an independent predictor of PCCs after c-VATS (odds ratio: 3.92, p‹0.001). The mE-PASS CRSf was useful for predicting the occurrence of PCCs in patients with lung cancer undergoing c-VATS lobectomy.