Morbidity and mortality in octogenarians with lung cancer undergoing pneumonectomy

• Published in: Archivos de bronconeumología (English ed.) Vol. 51; no. 5; p. 219
• Main Authors: Rodríguez, María, Gómez Hernández, María Teresa, Novoa, Nuria M, Aranda, José Luis, Jiménez, Marcelo F, Varela, Gonzalo
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01.05.2015
• Subjects: Age Factors; Aged; Aged, 80 and over; Body Mass Index; Cardiovascular Diseases - epidemiology; Case-Control Studies; Female; Forced Expiratory Volume; Humans; Life Expectancy; Lung Neoplasms - mortality; Lung Neoplasms - physiopathology; Lung Neoplasms - surgery; Male; Middle Aged; Patient Selection; Pneumonectomy - statistics & numerical data; Postoperative Complications - epidemiology; Postoperative Complications - physiopathology; Prevalence; Pulmonary Diffusing Capacity; Respiration Disorders - epidemiology; Respiration Disorders - physiopathology; Retrospective Studies; Neoplasias pulmonares; Surgical risk; Pulmonary neoplasms; Ancianos; Pneumonectomy; Neumonectomía; Riesgo quirúrgico; Elderly
• ISSN: 1579-2129; 1579-2129
• DOI: 10.1016/j.arbres.2014.07.008

Evaluate the restrictiveness of selection criteria for lung resection in lung cancer patients over 80 years of age compared to those applied in younger patients. Compare and analyze 30-day mortality and postoperative complications in both groups of patients. Case-controlled retrospective analysis. Consecutive patients undergoing elective anatomical lung resection. Population was divided into octogenarians (cases) and younger patients (controls). Variables determining surgical risk (BMI, FEV1%, postoperative FEV1%, FEV1/FVC, DLCO and pneumonectomy rate) were compared using either Wilcoxon or Chi-squared tests. Thirty-day mortality and morbidity odds ratio were calculated. A logistic regression model with bootstrap resampling was constructed, including postoperative complications as dependent variable and age and post-operative FEV1% as independent variables. Data were retrieved from a prospective database. No statistically significant differences were found in BMI (P=.40), FEV1% (P=.41), postoperative FEV1% (P=.23), FEV1/FVC (P=.23), DLCO (P=.76) and pneumonectomy rate (P=.90). Case mortality was 1.85% and control mortality was 1.26% (OR: 1.48). Cardiorespiratory complications occurred in 12.80% of younger subjects and in 13.21% of patients aged 80 years or older. (OR: 1.03). In the logistic regression, only FEV1% was related to postoperative complications (P<.005). Selection criteria for octogenarians are similar to those applied in the rest of the population. Advanced age is not a factor for increased 30-day mortality or postoperative morbidity.