Risk assessment by sex, FEV1.0%, procedures, and CONUT score for postoperative complications in lung cancer patients aged 75 or older

Abstract

【Introduction】The incidence of postoperative complications is high in elderly patients with lung cancer, but there is no method to assess the surgical risk. 【Methods】From January 2005 to September 2013, 191 surgical operations for lung cancer were performed in 75-year-old or older patients in our hospital. The patients were divided into 2 groups depending on the presence or absence of postoperative complications. Univariate analysis was performed to compare the background, nutritional condition, respiratory function, and surgical factors between the 2 groups. Using significant factors identified in the univariate analysis, we performed multivariate analysis to detect risk factors for postoperative complications. The patients were divided into 5 groups depending on the presence or absence of risk factors which were significant in multivariate analysis. We compared the postoperative complication rate among 5 groups (from groups 0 to 4). 【Results】The mean age of all patients was 78.4 years. Postoperative complications occurred in 47 patients (24.6%) and hospital deaths occurred in 2 patients (1.1%). Regarding the results of multivariate analysis, a male sex (P=0.00253), FEV1.0%≤70% (P=0.00381), segmentectomy or lobectomy (P=0.00293), and CONUT score≥2 (P=0.0175) were significant. The postoperative complication rate of group 3 was significantly higher than in groups 0, 1, and 2 (P=0.0144, P<0.001, and P=0.0124, respectively), and that of group 4 was significantly higher than in groups 0, 1, and 2 (P=0.0013, P<0.001, and P=0.0017, respectively). 【Conclusions】It is important to preoperatively assess not only the surgical procedure and respiratory functions, but also the nutritional condition and sex when conducting surgery for lung cancer in elderly patients in order to reduce the incidence of postoperative complications.