Validation of Thoracic Surgery Scoring System (Thoracoscore) in Turkish Population

Abstract

Objective: To validate the Thoracoscore, a scoring system designed to predict 30-day mortality in patients undergoing thoracic surgery in the Turkish population.Study Design: Observational study.Place and Duration of the Study: Department of Thoracic Surgery, Ondokuz Mayis University, Medical School, from January 2015 to June 2022.Methodology: Patients who underwent thoracic surgery under general anaesthesia were evaluated. Thoracoscore was calculated using the online calculator located at https://www.samiuc.es/thoracoscore-thoracic-surgery-scoring-system/. Using the area under the ROC curve (AUC), the sensitivity and specificity of the Thoracoscore in predicting morbidity and mortality were assessed.Results: The study included 745 patients (67.5% males and 32.5% females) with a mean age of 57.23 +/- 14.68 years. Nearly all of the patients underwent elective surgery (99.5%). In 56.9% of cases, the indication for thoracic surgery was malignancy. The 30-day and 90-day mortality rates of patients included in the study were 1.9% and 4.8%, respectively. The mean Thoracoscore was calculated to be-4.79 +/- 2.2 (Range:-7.37 to 7.37). In predicting morbidity, Thoracoscore had a sensitivity of 60.83% and a specificity of 73.12%. The sensitivity and specificity of Thoracoscore for predicting 30-day and 90-day mortality were calculated as being 85.7% and 68.7% for 30-day and 69.4% and 67.0% for 90-day, respectively.Conclusion: Although Thoracoscore's AUC had sufficient discrimination capacity, its sensitivity and specificity was found to be limited. In order to fully comprehend its limitations and accuracy, the authors believe that multicentric studies involving a greater number of patients and a control group of equal size are necessary.