Organ Function Index: A Predictive Marker of Operative Mortality Based on Multiple Organ Dysfunctions in Patients with Esophageal Cancer

Abstract

To evaluate the risk of transthoracic esophagectomy for cancer based on the overall impairment of vital organs, we examined pulmonary, cardiac, renal and hepatic functions using 18 markers in 35 patients between 1982 and 1984. A discriminant analysis proved useful in determining whether or not the patients would be at risk of operative mortality (operative death and hospital death), based on the overall impairment of vital organs. The accuracy of the prediction of operative mortality by this model, the organ function index (OFI), was 91.4%. The OFI was then applied to 66 patients seen between 1986 and 1991. During this period, a change in policy for performing transthoracic esophagectomy and perioperative care on patients with impairment of multiple organs was associated with a decrease in operative mortality. We conclude the OFI to be beneficial in evaluating the risk of operative mortality based on mild to moderate dysfunctions of multiple vital organs in patients with esophageal cancer.