Is the Parsimonious Eurolung risk model a good predictor for all populations? An external validation study

External validation was partially achieved. The Parsimonious Eurolung 1 score is moderately applicable for morbidity. The Parsimonious Eurolung 2 score is not validated for 30-day mortality in this cohort. It should not guide surgical eligibility, and this point can be generalized to other low-mortality settings. This study provides valuable insights into the performance of the Parsimonious Eurolung models in a specific national context while highlighting the ongoing challenges in risk prediction for thoracic surgery. The findings suggest a need for quality multicentric databases and more granular, population-specific risk models, potentially incorporating machine learning approaches.