STS Lobectomy for Lung Cancer Composite Score

The STS Lobectomy Composite Score comprises two domains:

1. Operative Mortality (death during the same hospitalization as surgery or within 30 days of the procedure)
2. Presence of at least one of these major complications: pneumonia, acute respiratory distress syndrome, bronchopleural fistula, pulmonary embolus, initial ventilator support greater than 48 hours, reintubation/respiratory failure, tracheostomy, myocardial infarction, or unexpected return to the operating room.

The composite score is created by a weighted combination of the above two domains resulting in a single composite score. Operative mortality and major complications were weighted inversely by their respective standard deviations across participants. This procedure is equivalent to first rescaling mortality and complications by their respective standard deviations and then assigning equal weighting to the rescaled mortality rate and rescaled complication rate. This is the same methodology used for other STS composite measures.

In addition to receiving a numeric score, participants are assigned to rating categories designated by the following:

1 star: lower-than expected performance
2 stars: as-expected-performance
3 start: higher-than-expected-performance

Patient Population: The STS GTSD was queried for all patients treated with lobectomy for lung cancer between January 1, 2014, and December 31, 2016. We excluded patients with non-elective status, occult or stage 0 tumors, American Society of Anesthesiologists class VI, and with missing data for age, sex, or discharge mortality status.

Time Window: 01/01/2014 - 12/31/2016

Model variables: Variables in the model: age, sex, year of operation, body mass index, hypertension, steroid therapy, congestive heart failure, coronary artery disease, peripheral vascular disease, reoperation, preoperative chemotherapy within 6 months, cerebrovascular disease, diabetes mellitus, renal failure, dialysis, past smoker, current smoker, forced expiratory volume in 1 second percent of predicted, Zubrod score (linear plus quadratic), American Society of Anesthesiologists class (linear plus quadratic), and pathologic stage.