Article Text

other Versions

PDF

Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude
  1. Trond-Eirik Strand (trond-eirik.strand{at}kreftregisteret.no)
  1. Cancer Registry of Norway, Norway
    1. Hans Rostad (hans.rostad{at}kreftregisteret.no)
    1. Cancer Registry of Norway, Norway
      1. Ronald AM Damhuis (damhuis{at}ikr.nl)
      1. Rotterdam Cancer Registry, Netherlands
        1. Jarle Norstein (jnorstein{at}aol.com)
        1. Private, Norway

          Abstract

          Introduction: Considerable variability in reported operative mortality rates and risk factors for mortality after surgery for lung cancer exists. Population-based data provide unbiased estimates and may aid in treatment selection.

          Methods: All lung cancer patients in Norway diagnosed from 1993 through 2005 were reported to the Cancer Registry of Norway (n=26,665). A total of 4,395 patients underwent surgical resection and were included for analysis. Data on demographics, tumours and treatment were registered. A subset of patients (n=1,844) was scored according to Charlson co-morbidity index. Potential factors influencing 30-day mortality were analyzed by logistic regression.

          Results: The overall postoperative mortality was 4.4% within 30 days with a declining trend in the period. Male sex (odds ratio 1.76), older age (age-band 70-79, odds ratio 3.38), right-sided tumour (odds ratio 1.73) and extensive procedures (pneumonectomy, odds ratio 4.54) were identified as risk factors for postoperative mortality in multivariate analysis. Postoperative mortality at high volume hospitals (³20 procedures/year)was lower, odds ratio 0.76 (p-value 0.076). Adjusted odds ratios 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 (p=0.017) for postoperative mortality. A prediction model for postoperative mortality is presented.

          Conclusions: Even though improvements have been observed in recent years with regard to postoperative mortality these findings indicate a further potential to optimize 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.

          • co-morbidity
          • hospital volume
          • prognostic models
          • thoracic surgery

          Statistics from Altmetric.com

          Request permissions

          If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

          Linked Articles