A risk score to predict postoperative complications after lobectomy in elderly lung cancer patients
Objective In elderly patients with lung cancer, the presumed fear of postoperative complications has resulted in the delivery of limited resection. Surgical decision-making for such patients would become easier if clinicians could predict who is at high risk of postoperative complications. The purpo...
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| Veröffentlicht in: | General thoracic and cardiovascular surgery 2018-09, Vol.66 (9), p.537-542 |
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| creator | Kawaguchi, Yo Hanaoka, Jun Ohshio, Yasuhiko Igarashi, Tomoyuki Kataoka, Yoko Okamoto, Keigo Kaku, Ryosuke Hayashi, Kazuki |
| description | Objective
In elderly patients with lung cancer, the presumed fear of postoperative complications has resulted in the delivery of limited resection. Surgical decision-making for such patients would become easier if clinicians could predict who is at high risk of postoperative complications. The purpose of this study is to propose a scoring system to predict the risk of postoperative complications for elderly patients with lung cancer.
Methods
We reviewed patients aged 75 years or older who underwent lobectomy for lung cancer at a single hospital (
n
= 199). A multivariable logistic regression model was utilized to determine risk factors for postoperative complications.
Results
Six risk factors for postoperative complications were identified, and we derived a risk score by assigning weights to these factors based on their odds ratios, as follows: Risk score = 7 × (performance status of 2) + 6 × (coronary artery disease) + 3 × (a history of cerebrovascular accident) + 2 × (restrictive ventilatory impairment) + 1 × (male sex) + 1 × (interstitial pneumonia). The postoperative complication rates in patients with risk scores of 0, 1–2, 3–5, 6–8, and 9–14 were 19, 29, 56, 68, and 90%, respectively.
Conclusions
The proposed risk score was able to predict the incidence of postoperative complications. The risk score can be used to identify high-risk patients and to select proper treatment strategies. |
| doi_str_mv | 10.1007/s11748-018-0960-8 |
| format | Article |
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In elderly patients with lung cancer, the presumed fear of postoperative complications has resulted in the delivery of limited resection. Surgical decision-making for such patients would become easier if clinicians could predict who is at high risk of postoperative complications. The purpose of this study is to propose a scoring system to predict the risk of postoperative complications for elderly patients with lung cancer.
Methods
We reviewed patients aged 75 years or older who underwent lobectomy for lung cancer at a single hospital (
n
= 199). A multivariable logistic regression model was utilized to determine risk factors for postoperative complications.
Results
Six risk factors for postoperative complications were identified, and we derived a risk score by assigning weights to these factors based on their odds ratios, as follows: Risk score = 7 × (performance status of 2) + 6 × (coronary artery disease) + 3 × (a history of cerebrovascular accident) + 2 × (restrictive ventilatory impairment) + 1 × (male sex) + 1 × (interstitial pneumonia). The postoperative complication rates in patients with risk scores of 0, 1–2, 3–5, 6–8, and 9–14 were 19, 29, 56, 68, and 90%, respectively.
Conclusions
The proposed risk score was able to predict the incidence of postoperative complications. The risk score can be used to identify high-risk patients and to select proper treatment strategies.</description><identifier>ISSN: 1863-6705</identifier><identifier>EISSN: 1863-6713</identifier><identifier>DOI: 10.1007/s11748-018-0960-8</identifier><identifier>PMID: 29956048</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged ; Aged, 80 and over ; Cardiac arrhythmia ; Cardiac Surgery ; Cardiology ; Cardiovascular disease ; Chronic obstructive pulmonary disease ; Coronary vessels ; Delirium ; Diabetes ; Female ; Fistula ; Histology ; Humans ; Logistic Models ; Lung cancer ; Lung Diseases, Interstitial - complications ; Lung Neoplasms - surgery ; Lymphatic system ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Morbidity ; Mortality ; Odds Ratio ; Original Article ; Outcome Assessment (Health Care) - methods ; Patients ; Pneumonectomy - methods ; Pneumonia ; Postoperative Complications ; Ratios ; Regression analysis ; Risk Assessment - methods ; Risk factors ; Statistical analysis ; Surgical Oncology ; Thoracic Surgery ; Tomography ; Vein & artery diseases</subject><ispartof>General thoracic and cardiovascular surgery, 2018-09, Vol.66 (9), p.537-542</ispartof><rights>The Japanese Association for Thoracic Surgery 2018</rights><rights>The Japanese Association for Thoracic Surgery 2018.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-ebb87e7a9e9ff6788cc3f8a1761176e55f9b563950353f87cca00add14e595fa3</citedby><cites>FETCH-LOGICAL-c462t-ebb87e7a9e9ff6788cc3f8a1761176e55f9b563950353f87cca00add14e595fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11748-018-0960-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2918739893?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21388,21389,27924,27925,33530,33531,33744,33745,41488,42557,43659,43805,51319,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29956048$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kawaguchi, Yo</creatorcontrib><creatorcontrib>Hanaoka, Jun</creatorcontrib><creatorcontrib>Ohshio, Yasuhiko</creatorcontrib><creatorcontrib>Igarashi, Tomoyuki</creatorcontrib><creatorcontrib>Kataoka, Yoko</creatorcontrib><creatorcontrib>Okamoto, Keigo</creatorcontrib><creatorcontrib>Kaku, Ryosuke</creatorcontrib><creatorcontrib>Hayashi, Kazuki</creatorcontrib><title>A risk score to predict postoperative complications after lobectomy in elderly lung cancer patients</title><title>General thoracic and cardiovascular surgery</title><addtitle>Gen Thorac Cardiovasc Surg</addtitle><addtitle>Gen Thorac Cardiovasc Surg</addtitle><description>Objective
In elderly patients with lung cancer, the presumed fear of postoperative complications has resulted in the delivery of limited resection. Surgical decision-making for such patients would become easier if clinicians could predict who is at high risk of postoperative complications. The purpose of this study is to propose a scoring system to predict the risk of postoperative complications for elderly patients with lung cancer.
Methods
We reviewed patients aged 75 years or older who underwent lobectomy for lung cancer at a single hospital (
n
= 199). A multivariable logistic regression model was utilized to determine risk factors for postoperative complications.
Results
Six risk factors for postoperative complications were identified, and we derived a risk score by assigning weights to these factors based on their odds ratios, as follows: Risk score = 7 × (performance status of 2) + 6 × (coronary artery disease) + 3 × (a history of cerebrovascular accident) + 2 × (restrictive ventilatory impairment) + 1 × (male sex) + 1 × (interstitial pneumonia). The postoperative complication rates in patients with risk scores of 0, 1–2, 3–5, 6–8, and 9–14 were 19, 29, 56, 68, and 90%, respectively.
Conclusions
The proposed risk score was able to predict the incidence of postoperative complications. The risk score can be used to identify high-risk patients and to select proper treatment strategies.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Coronary vessels</subject><subject>Delirium</subject><subject>Diabetes</subject><subject>Female</subject><subject>Fistula</subject><subject>Histology</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Lung cancer</subject><subject>Lung Diseases, Interstitial - complications</subject><subject>Lung Neoplasms - surgery</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Odds Ratio</subject><subject>Original Article</subject><subject>Outcome Assessment (Health Care) - methods</subject><subject>Patients</subject><subject>Pneumonectomy - methods</subject><subject>Pneumonia</subject><subject>Postoperative Complications</subject><subject>Ratios</subject><subject>Regression analysis</subject><subject>Risk Assessment - methods</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Surgical Oncology</subject><subject>Thoracic Surgery</subject><subject>Tomography</subject><subject>Vein & artery diseases</subject><issn>1863-6705</issn><issn>1863-6713</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1LxDAQhoMorl8_wIsEvHipJk3zdVwWv0DwoueQplOptk1NUmH_vZHVFQQPQ2aYZ95J8iJ0SsklJUReRUplpQpCc2hBCrWDDqgSrBCSst1tTvgCHcb4SggXivJ9tCi15oJU6gC5JQ5dfMPR-QA4eTwFaDqX8ORj8hMEm7oPwM4PU9-5XPgxYtsmCLj3NbjkhzXuRgx9A6Ff434eX7Czo8vAlHEYUzxGe63tI5x8n0fo-eb6aXVXPDze3q-WD4WrRJkKqGslQVoNum2FVMo51ipLpcjPFMB5q2sumOaE8dyQzllCbNPQCrjmrWVH6GKjOwX_PkNMZuiig763I_g5mpKIUjFGK5nR8z_oq5_DmG9nSk2VZFpplim6oVzwMQZozRS6wYa1ocR8OWA2DpjsgPlywKg8c_atPNcDNNuJny_PQLkBYm6NLxB-V_-v-gm7gZIH</recordid><startdate>20180901</startdate><enddate>20180901</enddate><creator>Kawaguchi, Yo</creator><creator>Hanaoka, Jun</creator><creator>Ohshio, Yasuhiko</creator><creator>Igarashi, Tomoyuki</creator><creator>Kataoka, Yoko</creator><creator>Okamoto, Keigo</creator><creator>Kaku, Ryosuke</creator><creator>Hayashi, Kazuki</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20180901</creationdate><title>A risk score to predict postoperative complications after lobectomy in elderly lung cancer patients</title><author>Kawaguchi, Yo ; Hanaoka, Jun ; Ohshio, Yasuhiko ; Igarashi, Tomoyuki ; Kataoka, Yoko ; Okamoto, Keigo ; Kaku, Ryosuke ; Hayashi, Kazuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-ebb87e7a9e9ff6788cc3f8a1761176e55f9b563950353f87cca00add14e595fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Coronary vessels</topic><topic>Delirium</topic><topic>Diabetes</topic><topic>Female</topic><topic>Fistula</topic><topic>Histology</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Lung cancer</topic><topic>Lung Diseases, Interstitial - complications</topic><topic>Lung Neoplasms - surgery</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Odds Ratio</topic><topic>Original Article</topic><topic>Outcome Assessment (Health Care) - methods</topic><topic>Patients</topic><topic>Pneumonectomy - methods</topic><topic>Pneumonia</topic><topic>Postoperative Complications</topic><topic>Ratios</topic><topic>Regression analysis</topic><topic>Risk Assessment - methods</topic><topic>Risk factors</topic><topic>Statistical analysis</topic><topic>Surgical Oncology</topic><topic>Thoracic Surgery</topic><topic>Tomography</topic><topic>Vein & artery diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kawaguchi, Yo</creatorcontrib><creatorcontrib>Hanaoka, Jun</creatorcontrib><creatorcontrib>Ohshio, Yasuhiko</creatorcontrib><creatorcontrib>Igarashi, Tomoyuki</creatorcontrib><creatorcontrib>Kataoka, Yoko</creatorcontrib><creatorcontrib>Okamoto, Keigo</creatorcontrib><creatorcontrib>Kaku, Ryosuke</creatorcontrib><creatorcontrib>Hayashi, Kazuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>General thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kawaguchi, Yo</au><au>Hanaoka, Jun</au><au>Ohshio, Yasuhiko</au><au>Igarashi, Tomoyuki</au><au>Kataoka, Yoko</au><au>Okamoto, Keigo</au><au>Kaku, Ryosuke</au><au>Hayashi, Kazuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A risk score to predict postoperative complications after lobectomy in elderly lung cancer patients</atitle><jtitle>General thoracic and cardiovascular surgery</jtitle><stitle>Gen Thorac Cardiovasc Surg</stitle><addtitle>Gen Thorac Cardiovasc Surg</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>66</volume><issue>9</issue><spage>537</spage><epage>542</epage><pages>537-542</pages><issn>1863-6705</issn><eissn>1863-6713</eissn><abstract>Objective
In elderly patients with lung cancer, the presumed fear of postoperative complications has resulted in the delivery of limited resection. Surgical decision-making for such patients would become easier if clinicians could predict who is at high risk of postoperative complications. The purpose of this study is to propose a scoring system to predict the risk of postoperative complications for elderly patients with lung cancer.
Methods
We reviewed patients aged 75 years or older who underwent lobectomy for lung cancer at a single hospital (
n
= 199). A multivariable logistic regression model was utilized to determine risk factors for postoperative complications.
Results
Six risk factors for postoperative complications were identified, and we derived a risk score by assigning weights to these factors based on their odds ratios, as follows: Risk score = 7 × (performance status of 2) + 6 × (coronary artery disease) + 3 × (a history of cerebrovascular accident) + 2 × (restrictive ventilatory impairment) + 1 × (male sex) + 1 × (interstitial pneumonia). The postoperative complication rates in patients with risk scores of 0, 1–2, 3–5, 6–8, and 9–14 were 19, 29, 56, 68, and 90%, respectively.
Conclusions
The proposed risk score was able to predict the incidence of postoperative complications. The risk score can be used to identify high-risk patients and to select proper treatment strategies.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>29956048</pmid><doi>10.1007/s11748-018-0960-8</doi><tpages>6</tpages></addata></record> |
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| ispartof | General thoracic and cardiovascular surgery, 2018-09, Vol.66 (9), p.537-542 |
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| source | MEDLINE; ProQuest Central (Alumni Edition); SpringerNature Journals; ProQuest Central UK/Ireland; ProQuest Central |
| subjects | Aged Aged, 80 and over Cardiac arrhythmia Cardiac Surgery Cardiology Cardiovascular disease Chronic obstructive pulmonary disease Coronary vessels Delirium Diabetes Female Fistula Histology Humans Logistic Models Lung cancer Lung Diseases, Interstitial - complications Lung Neoplasms - surgery Lymphatic system Male Medicine Medicine & Public Health Middle Aged Morbidity Mortality Odds Ratio Original Article Outcome Assessment (Health Care) - methods Patients Pneumonectomy - methods Pneumonia Postoperative Complications Ratios Regression analysis Risk Assessment - methods Risk factors Statistical analysis Surgical Oncology Thoracic Surgery Tomography Vein & artery diseases |
| title | A risk score to predict postoperative complications after lobectomy in elderly lung cancer patients |
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