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Andrew Kaufman



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    P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.16-01 - Risk Factors for Short-Term Post-Operative Events Following Lung Cancer Resection (ID 1381)

      10:15 - 18:15  |  Author(s): Andrew Kaufman

      • Abstract
      • Slides

      Background

      Lung cancer represents 13% of all newly diagnosed US cancers and is the leading cause of all cancer deaths (25%). Reducing postoperative complications and improving quality of life following surgery remains central when providing treatment. We examined risk factors for short-term post-opeartive complications following lung cancer resection in patients treated at Mount Sinai, New York City.

      Method

      Data was selected from the General Thoracic Surgery Database (2012-2018). Patients with a primary diagnosis of lung cancer who underwent a Lobectomy (n = 603) or a Wedge resection (n = 659) were included. Preoperative assessments of health, including the Zubrod Performance Score, % predicted FEV1, heart (congestive heart failure, coronary artery disease, peripheral vascular disease) lung (pulmonary hypertension, chronic obstructive pulmonary disease, and interstitial fibrosis) comorbidities, diabetes, and smoking status were measured for each patient. The primary outcome was the occurence of at least one post-operative event (pulmonary/ cardiovascular/gastrointestinal/neurological complications, infections, and unexpected readmissions to the operating room or intensive care unit) during their hospital stay or within 30 days of their surgery; SAS v9.4 was used for statistical analyses.

      Result

      There were 1262 patients (age 18-95 years); 60% were female, 64% were White, and 55% were Stage 1a / 1b. More patients underwent surgery with a Video-Assisted Thoracoscopic Surgery (VATS) approach (58%) rather than an Open approach (42%). The majority of patients was classified as past smokers (58%), while the remainder were never (27%) and current (15%) smokers. 17% of patients presented with at least one heart comorbidity, while 21% with at least one lung comorbidity. At multivariable analysis, female gender (ORadj 0.64, 95% CI: 0.49-0.96), Wedge resection (ORadj 0.64, 95% CI: 0.44-0.92 compared to Lobectomy), VATS (ORadj 0.54, 95% CI: 0.38-0.77 compared to an OPEN approach), and an increasing % predicted FEV1 were inversely associated with the occurence of a post-operative event. Increasing age (ORadj 1.03, 95% CI: 1.01-1.04), Zubrod performance score (ORadj 1.53, 95% CI: 1.21-1.93), duration of surgery in hours (ORadj 1.10, 95% CI: 1.01-1.21), and currently smoking (ORadj 1.97, 95% CI: 1.14-3.40) were associated with increased odds of a post-operative event.

      Conclusion

      Significant risk factors exist for the occurence of a short-term post-operative event following lung cancer resection, which should be recognized to improve post-surgery quality of life. A VATS wedge resection should be utilized whenever appropriate to reduce the likelihood of post-operative complications.

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