HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Pankaj Kumar Mishra Ragini Pandey Michael J. Shackcloth Antony D. Grayson Richard D. Page Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Mishra, P. K. Articles by Page, R. D. Search for Related Content PubMed Articles by Mishra, P. K. Articles by Page, R. D. Related Collections Lung - cancer

Cardiac comorbidity is not a risk factor for mortality and morbidity following surgery for primary non-small cell lung cancer

^a Department of Thoracic Surgery, The Cardiothoracic Centre Liverpool, United Kingdom
^b Department of Clinical Governance, The Cardiothoracic Centre Liverpool, United Kingdom

Received 7 July 2008; received in revised form 21 October 2008; accepted 27 October 2008.

^_* Corresponding author. Address: The Cardiothoracic Centre NHS Trust, Thomas Drive, Liverpool L14 3PE, United Kingdom. Tel.: +44 151 228 1616; fax: +44 151 288 2371. (Email: michael.shackcloth{at}ctc.nhs.uk).

Objective: We examined the effect of cardiac comorbidity on mortality and postoperative complications following surgery for primary non-small cell lung cancer. Methods: Between October 2001 to December 2005, 1067 consecutive patients underwent lung resection for primary cancer within a single centre; patient data was collected prospectively. Two hundred and seventy-one patients had a history of cardiac comorbidity, which included 196 angina, 118 myocardial infarction, 36 revascularisation, 10 congestive cardiac failure and 19 rhythm disorders (numbers not mutually exclusive). To account for differences in case-mix we used logistic regression to develop a propensity score for cardiac comorbidity group membership and then performed a propensity-matched analysis. Kaplan–Meier curves were used to assess follow-up mortality. Results: Patients with cardiac comorbidity were more likely to be hypertensive, have severe dyspnoea, diabetes, current or ex-smokers and were older. After performing propensity matching to account for these differences we successfully matched 199 patients with cardiac comorbidity to 398 patients with no cardiac history. There was no difference in in-hospital mortality (2.5% vs 3%, p = 0.73), myocardial infarction (0.5% vs 0.3%, p > 0.99), arrhythmia (15.6% vs 14.1%, p = 0.62), renal failure (2% vs 1.5%, p = 0.65), stroke (0.5% vs 0.3%, p > 0.99), respiratory insufficiency (4% vs 3.3%, p = 0.64), reintubation (1% vs 2.5%, p = 0.35), tracheostomy (4% vs 7.8%, p = 0.08), intensive care readmission (8.5% vs 6.5%, p = 0.37) and length of stay (8 days vs 8 days, p = 0.98). Three-year survival was similar (61.4% vs 56.2%, p = 0.39). No differences in outcomes existed with different cardiac conditions. Conclusion: With careful assessment and patient selection, patients with cardiac comorbidity were not found to be at increased risk of mortality and morbidity following lung resection for primary non-small cell lung cancer in a propensity-matched population.

Key Words: Cardiac comorbidity • Lung resection • Lung cancer • Mortality • Morbidity