Personal and hospital factors associated with limited surgical resection for lung cancer, in-hospital mortality and complications in New York State
Corresponding Author
Emanuela Taioli MD, PhD
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
Correspondence
Emanuela Taioli MD, PhD, Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1133, New York, NY 10029.
Email: [email protected]
Search for more papers by this authorBian Liu PhD
Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
Search for more papers by this authorDaniel G. Nicastri MD
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
Search for more papers by this authorWil Lieberman-Cribbin MPH
Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
Search for more papers by this authorEmanuele Leoncini PhD
Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
Search for more papers by this authorRaja M. Flores MD
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
Search for more papers by this authorCorresponding Author
Emanuela Taioli MD, PhD
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
Correspondence
Emanuela Taioli MD, PhD, Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1133, New York, NY 10029.
Email: [email protected]
Search for more papers by this authorBian Liu PhD
Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
Search for more papers by this authorDaniel G. Nicastri MD
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
Search for more papers by this authorWil Lieberman-Cribbin MPH
Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
Search for more papers by this authorEmanuele Leoncini PhD
Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
Search for more papers by this authorRaja M. Flores MD
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
Search for more papers by this authorAbstract
Background and Objectives
Early stage lung cancer is generally treated with surgical resection. The objective of the study was to identify patient and hospital characteristics associated with the type of lung cancer surgical approach utilized in New York State (NYS), and to assess in-hospital adverse events.
Methods
A total of 33 960 lung cancer patients who underwent limited resection (LR) or lobectomy (L) were selected from the NYS Statewide Planning and Research Cooperative System database (1995-2012).
Results
LR patients were more likely to be older (adjusted odds ratio ORadj and [95% confidence interval]: 1.01 [1.01-1.02]), female (ORadj: 1.11 [1.06-1.16]), Black (ORadj: 1.17 [1.08-1.27]), with comorbidities (ORadj: 1.08 [1.03-1.14]), and treated in more recent years than L patients. Length of stay and complications were significantly less after LR than L (ORadj: 0.56 [0.53-0.58] and 0.65 [0.62-0.69]); in-hospital mortality was similar (ORadj: 0.93 [0.81-1.07]), and was positively associated with age and urgent/emergency admission, but inversely associated with female gender, private insurance, recent admission year, and surgery volume.
Conclusions
There was a growing trend toward LR, which was more likely to be performed in older patients with comorbidities. In-hospital outcomes were better after LR than L, and were affected by patient and hospital characteristics.
Supporting Information
Additional Supporting Information may be found online in the supporting information tab for this article.
| Filename | Description |
|---|---|
| jso24697-sup-0001-SuppData-S1.docx22.9 KB | Table S1. Odds of having limited resection versus lobectomy according to patient and hospital characteristics with additional adjustment for the variable “metastatic cancer”. Figure S1. Flow chart of patient selection. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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