BACKGROUND: There is considerable variability in reported postoperative mortality and risk factors for mortality after surgery for lung cancer. Population-based data provide unbiased estimates and may aid in treatment selection. METHODS: All patients diagnosed with lung cancer in Norway from 1993 to the end of 2005 were reported to the Cancer Registry of Norway (n = 26 665). A total of 4395 patients underwent surgical resection and were included in the analysis. Data on demographics, tumour characteristics and treatment were registered. A subset of 1844 patients was scored according to the Charlson co-morbidity index. Potential factors influencing 30-day mortality were analysed by logistic regression. RESULTS: The overall postoperative mortality rate was 4.4% within 30 days with a declining trend in the period. Male sex (OR 1.76), older age (OR 3.38 for age band 70-79 years), right-sided tumours (OR 1.73) and extensive procedures (OR 4.54 for pneumonectomy) were identified as risk factors for postoperative mortality in multivariate analysis. Postoperative mortality at high-volume hospitals (> or = 20 procedures/year) was lower (OR 0.76, p = 0.076). Adjusted ORs for postoperative mortality at individual hospitals ranged from 0.32 to 2.28. The Charlson co-morbidity index was identified as an independent risk factor for postoperative mortality (p = 0.017). A prediction model for postoperative mortality is presented. CONCLUSIONS: Even though improvements in postoperative mortality have been observed in recent years, these findings indicate a further potential to optimise the surgical treatment of lung cancer. Hospital treatment results varied but a significant volume effect was not observed. Prognostic models may identify patients requiring intensive postoperative care.
BACKGROUND: There is considerable variability in reported postoperative mortality and risk factors for mortality after surgery for lung cancer. Population-based data provide unbiased estimates and may aid in treatment selection. METHODS: All patients diagnosed with lung cancer in Norway from 1993 to the end of 2005 were reported to the Cancer Registry of Norway (n = 26 665). A total of 4395 patients underwent surgical resection and were included in the analysis. Data on demographics, tumour characteristics and treatment were registered. A subset of 1844 patients was scored according to the Charlson co-morbidity index. Potential factors influencing 30-day mortality were analysed by logistic regression. RESULTS: The overall postoperative mortality rate was 4.4% within 30 days with a declining trend in the period. Male sex (OR 1.76), older age (OR 3.38 for age band 70-79 years), right-sided tumours (OR 1.73) and extensive procedures (OR 4.54 for pneumonectomy) were identified as risk factors for postoperative mortality in multivariate analysis. Postoperative mortality at high-volume hospitals (> or = 20 procedures/year) was lower (OR 0.76, p = 0.076). Adjusted ORs for postoperative mortality at individual hospitals ranged from 0.32 to 2.28. The Charlson co-morbidity index was identified as an independent risk factor for postoperative mortality (p = 0.017). A prediction model for postoperative mortality is presented. CONCLUSIONS: Even though improvements in postoperative mortality have been observed in recent years, these findings indicate a further potential to optimise the surgical treatment of lung cancer. Hospital treatment results varied but a significant volume effect was not observed. Prognostic models may identify patients requiring intensive postoperative care.
Authors: D H Harpole; M M DeCamp; J Daley; K Hur; C A Oprian; W G Henderson; S F Khuri Journal: J Thorac Cardiovasc Surg Date: 1999-05 Impact factor: 5.209
Authors: Alex G Little; Valerie W Rusch; James A Bonner; Laurie E Gaspar; Mark R Green; W Richard Webb; Andrew K Stewart Journal: Ann Thorac Surg Date: 2005-12 Impact factor: 4.330
Authors: D Moro-Sibilot; A Aubert; S Diab; S Lantuejoul; P Fourneret; E Brambilla; C Brambilla; P Y Brichon Journal: Eur Respir J Date: 2005-09 Impact factor: 16.671
Authors: Maryska L G Janssen-Heijnen; Saskia Houterman; Valery E P P Lemmens; Marieke W J Louwman; Huub A A M Maas; Jan Willem W Coebergh Journal: Crit Rev Oncol Hematol Date: 2005-09 Impact factor: 6.312
Authors: Samuel Cykert; Peggye Dilworth-Anderson; Michael H Monroe; Paul Walker; Franklin R McGuire; Giselle Corbie-Smith; Lloyd J Edwards; Audrina Jones Bunton Journal: JAMA Date: 2010-06-16 Impact factor: 56.272
Authors: Pamela Samson; Aalok Patel; Traves D Crabtree; Daniel Morgensztern; Cliff G Robinson; Graham A Colditz; Saiama Waqar; Daniel Kreisel; A Sasha Krupnick; G Alexander Patterson; Stephen Broderick; Bryan F Meyers; Varun Puri Journal: Ann Thorac Surg Date: 2015-07-28 Impact factor: 4.330
Authors: Ellie S Powell; Adrian C Pearce; David Cook; Paul Davies; Ehab Bishay; Geoffrey M R Bowler; Fang Gao Journal: J Cardiothorac Surg Date: 2009-07-30 Impact factor: 1.637