PATIENT AND HOSPITAL CHARACTERISTICS RELATED TO IN-HOSPITAL MORTALITY AFTER LUNG-CANCER RESECTION
PATIENT AND HOSPITAL CHARACTERISTICS RELATED TO IN-HOSPITAL MORTALITY AFTER LUNG-CANCER RESECTION
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DOI：
10.1378/chest.101.5.1332
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发表时间：
1992-05-01
期刊：
影响因子：
9.6
通讯作者：
MARK, DH
中科院分区：
文献类型：
--
作者：
ROMANO, PS;MARK, DH
最近来自学术中心的几份报告记录了肺癌手术后非常低的术后死亡率。然而，将这些研究推广到社区医院可能受到报告偏倚的限制。从加州医院出院摘要中，我们确定了12，439名在1983年1月至1986年12月期间因肺或支气管肿瘤接受肺切除术的成人。楔形切除术后的住院死亡率为3.5%，节段切除术后为3.7%，肺叶切除术后为4.2%，全肺切除术后为11.6%。在多变量回归模型中，院内死亡的重要预测因素包括年龄60岁或以上、男性、扩大切除、慢性肺或心脏病、糖尿病和医院容量。高容量医院比低容量医院的结果更好，尽管无法测量的疾病严重程度可能是一个混杂因素。这个以社区为基础的样本的总体死亡率超过了选定中心的报告，为患者提供了更好的建议基础。
Several recent reports from academic centers have documented very low postoperative mortality after lung cancer surgery. However, generalizing these studies to community hospitals is potentially limited by reporting bias. From California hospital discharge abstracts, we identified 12,439 adults who underwent pulmonary resection for lung or bronchial tumors between january 1983 and December 1986. In-hospital mortality was 3.S percent after wedge resection, 3.7 percent after segmental resection, 4.2 percent after lobectomy, and 11.6 percent after pneumonectomy. In multivariate regression models, the significant predictors of in-hospital death included age 60 years or more, male gender, extended resection, chronic lung or heart disease, diabetes and hospital volume. High-volume hospitals experienced better outcomes than low-volume hospitals, although unmeasured severity of illness may be a confounder. The overall mortality in this community-based sample exceeds that reported by selected centers and provides a better foundation for advising patients.