TY - JOUR
T1 - Seasonal variation influences outcomes following lung cancer resections
AU - LaPar, Damien J.
AU - Nagji, Alykhan S.
AU - Bhamidipati, Castigliano M.
AU - Kozower, Benjamin D.
AU - Lau, Christine L.
AU - Ailawadi, Gorav
AU - Jones, David R.
N1 - Funding Information:
§§ Funding: This study was supported by Award Number T32HL007849 (DJL, CMB) from the National Heart, Lung, And Blood Institute and the Thoracic Surgery Foundation for Research and Education Research Grant (GA) and Fellowship (ASN). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, And Blood Institute or the National Institutes of Health.0. * Corresponding author. Address: PO Box 800679, Charlottesville, VA 22908-0679, USA. Tel.: +1 434 243 6443; fax: +1 434 982 1026. E-mail address: drj8q@virginia.edu (D.R. Jones).
PY - 2011/7
Y1 - 2011/7
N2 - Objective: The effect of seasonal variation on postoperative outcomes following lung cancer resections is unknown. We hypothesized that postoperative outcomes following surgical resection for lung cancer within the United States would not be impacted by operative season. Methods: From 2002 to 2007, 182. 507 isolated lung cancer resections (lobectomy (n=147 937), sublobar resection (n=21. 650), and pneumonectomy (n=13. 916)) were evaluated using the Nationwide Inpatient Sample (NIS) database. Patients were stratified according to operative season: spring (n=47. 382), summer (n=46. 131), fall (n=45. 370) and winter (n=43. 624). Multivariate regression models were applied to assess the effect of operative season on adjusted postoperative outcomes. Results: Patient co-morbidities and risk factors were similar despite the operative season. Lobectomy was the most common operation performed: spring (80.0%), summer (81.3%), fall (81.8%), and winter (81.1%). Lung cancer resections were more commonly performed at large, high-volume (>75th percentile operative volume) centers (P<0.001). Unadjusted mortality was lowest during the spring (2.6%, P<0.001) season compared with summer (3.1%), fall (3.0%) and winter (3.2%), while complications were most common in the fall (31.7%, P<0.001). Hospital length of stay was longest for operations performed in the winter season (8.92±0.11 days, P<0.001). Importantly, multivariable logistic regression revealed that operative season was an independent predictor of in-hospital mortality (P<0.001) and of postoperative complications (P<0.001). Risk-adjusted odds of in-hospital mortality were increased for lung cancer resections occurring during all other seasons compared with those occurring in the spring. Conclusions: Outcomes following surgical resection for lung cancer are independently influenced by time of year. Risk-adjusted in-hospital mortality and hospital length of stay were lowest during the spring season.
AB - Objective: The effect of seasonal variation on postoperative outcomes following lung cancer resections is unknown. We hypothesized that postoperative outcomes following surgical resection for lung cancer within the United States would not be impacted by operative season. Methods: From 2002 to 2007, 182. 507 isolated lung cancer resections (lobectomy (n=147 937), sublobar resection (n=21. 650), and pneumonectomy (n=13. 916)) were evaluated using the Nationwide Inpatient Sample (NIS) database. Patients were stratified according to operative season: spring (n=47. 382), summer (n=46. 131), fall (n=45. 370) and winter (n=43. 624). Multivariate regression models were applied to assess the effect of operative season on adjusted postoperative outcomes. Results: Patient co-morbidities and risk factors were similar despite the operative season. Lobectomy was the most common operation performed: spring (80.0%), summer (81.3%), fall (81.8%), and winter (81.1%). Lung cancer resections were more commonly performed at large, high-volume (>75th percentile operative volume) centers (P<0.001). Unadjusted mortality was lowest during the spring (2.6%, P<0.001) season compared with summer (3.1%), fall (3.0%) and winter (3.2%), while complications were most common in the fall (31.7%, P<0.001). Hospital length of stay was longest for operations performed in the winter season (8.92±0.11 days, P<0.001). Importantly, multivariable logistic regression revealed that operative season was an independent predictor of in-hospital mortality (P<0.001) and of postoperative complications (P<0.001). Risk-adjusted odds of in-hospital mortality were increased for lung cancer resections occurring during all other seasons compared with those occurring in the spring. Conclusions: Outcomes following surgical resection for lung cancer are independently influenced by time of year. Risk-adjusted in-hospital mortality and hospital length of stay were lowest during the spring season.
KW - Lung Cancer
KW - Outcomes
KW - Season
KW - Surgery
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U2 - 10.1016/j.ejcts.2010.11.023
DO - 10.1016/j.ejcts.2010.11.023
M3 - Article
C2 - 21169031
AN - SCOPUS:79958011322
SN - 1010-7940
VL - 40
SP - 83
EP - 90
JO - European Journal of Cardio-Thoracic Surgery
JF - European Journal of Cardio-Thoracic Surgery
IS - 1
ER -