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A risk score to predict postoperative complications after lobectomy in elderly lung cancer patients

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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.

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Authors and Affiliations

  1. Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Tsukinowacho, Seta, Otsu, Shiga, 502-2192, Japan

    Yo Kawaguchi, Jun Hanaoka, Yasuhiko Ohshio, Tomoyuki Igarashi, Yoko Kataoka, Keigo Okamoto, Ryosuke Kaku & Kazuki Hayashi

  2. Division of General Thoracic Surgery, Kusatsu General Hospital, Kusatsu, Shiga, Japan

    Yo Kawaguchi

Authors
  1. Yo Kawaguchi
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  2. Jun Hanaoka
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  3. Yasuhiko Ohshio
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  4. Tomoyuki Igarashi
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  5. Yoko Kataoka
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  6. Keigo Okamoto
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  7. Ryosuke Kaku
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  8. Kazuki Hayashi
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Corresponding author

Correspondence to Yo Kawaguchi.

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The authors have no conflicts of interest that exist with any companies/organizations whose products or services may be discussed in this article.

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Kawaguchi, Y., Hanaoka, J., Ohshio, Y. et al. A risk score to predict postoperative complications after lobectomy in elderly lung cancer patients. Gen Thorac Cardiovasc Surg 66, 537–542 (2018). https://doi.org/10.1007/s11748-018-0960-8

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  • DOI: https://doi.org/10.1007/s11748-018-0960-8

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