Abstract
Background
This study reports the methods used to review the Composite Performance Score (CPS)
along with a reference table, which will be used in the upcoming ESTS Quality Certification
Program.
Methods
Data from 4303 patients who underwent pulmonary resection (July 2007–January 2010)
were captured in the ESTS database and used for the present analysis. Only patients
submitted from units contributing at least 100 consecutive lung resections were used
for developing the score.
According to the best available evidence the following measures were selected for
each surgical domain: preoperative care (1. % of DLCO measurement in patients submitted
to major anatomic resections; 2. % of preoperative invasive mediastinal staging in
patients with clinically suspicious N2 disease), operative care (% of systematic lymph
node dissection), outcomes (risk-adjusted cardiopulmonary morbidity and mortality
rates). Morbidity and mortality risk-models were developed by logistic regression
and validated by bootstrap analyses. Individual processes and outcomes scores were
rescaled according to their standard deviations and summed to generate the CPS. Units
were rated accordingly and a percentile reference table was produced.
Results
Risk-adjusted survival and absence of morbidity rates varied from 91.5% to 100%, and
from 50.2% to 97.5%, respectively. CPS ranged from −4.038 to 1.24. The 50% percentile
of CPS corresponded to 0.404.
Conclusions
A revised Composite Performance Score was developed and a reference table presented
to be used as a benchmark for the ESTS Quality Certification program.
Keywords
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Article info
Publication history
Accepted:
June 8,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
