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Eur J Cardiothorac Surg 2003;23:30-34
© 2003 Elsevier Science NL
a Rotterdam Oncological Thoracic Studygroup (ROTS), Department of Cardio-Thoracic Surgery, Erasmus Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
b Department of Pulmonology, Erasmus Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
c Rotterdam Cancer Registry, Erasmus Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
Received 2 August 2002; received in revised form 15 October 2002; accepted 21 October 2002.
* Corresponding author. Tel.: +31-10-463-5412; fax: +31-10-463-3993
e-mail: kappetein{at}thch.azr.nl
Objective: To validate the influence of the Charlson comorbidity index (CCI) in patients with operated primary non-small cell lung cancer. Methods: From January 1996 to December 2001, 205 consecutive resections for non-small cell lung cancer were performed at the Erasmus Medical Center Rotterdam. The patients ranged in age from 29 to 82 years, with a mean age of 64 years. In a retrospective study, each patient was scaled according to the CCI and the complications of surgery were determined. Results: The hospital mortality was 2.4% (5/205). Of the 205 patients 167 (32.7%) experienced minor complications and 32 (15.6%) major complications. In univariate analysis, gender, grades 3–4 of the CCI, any prior tumor treated in the last 5 years and chronic pulmonary disease were significant predictors of adverse outcome. Multivariate analysis showed that only grades 3–4 of the CCI was predictive (odds ratio=9.8; 95% confidence interval=2.1–45.9). Although only comorbidity grades 3–4 was a significant predictor, for every increase of the comorbidity grade the relative risk of adverse outcome showed a slight increase. Conclusion: The CCI is strongly correlated with higher risk of surgery in primary non-small cell lung cancer patients and is a better predictor than individual risk factors.
Key Words: Charlson comorbidity index • Lung cancer • Mortality • Morbidity • Surgery
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