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E. Leoncini
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P1.01 - Poster Session with Presenters Present (ID 453)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Epidemiology/Tobacco Control and Cessation/Prevention
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.01-029 - Personal and Hospital Factors Associated with Limited Surgical Resection, In-Hospital Mortality and Complications in New York State (ID 5359)
14:30 - 14:30 | Author(s): E. Leoncini
- Abstract
Background:
Lung cancer represents 13.4% of all newly diagnosed US cancers and 27.1% of all cancer deaths. Early stage lung cancer is generally treated with surgical resection. Many patient- and hospital-level factors influence the selection of appropriate surgical procedures and their outcome. We identified patient- and hospital-level characteristics influencing the type of lung cancer surgical approach utilized in New York State and assessed in-hospital complications and mortality.
Methods:
Patients were selected from the Statewide Planning and Research Cooperative System, SPARCS (1995-2012) based on ICD-9-CM codes of diagnosis (162 and 165) and procedures (32.0-32.9). Surgery was categorized into: limited resection (LR: 32.2-32.3), lobectomy (L: 32.4), and pneumonectomy (P: 32.5-32.6). Statistical analyses were performed in SAS v9.4 and ArcMap v10.3.1.
Results:
There were 36,460 patients (age 60-75 years); 56% underwent L, 37% LR, and 7% P. LR patients were more likely to be older (OR~adj~ 1.01, 95%CI [1.01-1.02]), female (OR~adj~ 1.10 [1.06-1.15]), Black (OR~adj~ 1.24 [1.15-1.34]), with comorbidities (OR~adj~ 1.10 [1.04-1.16]) than L patients. Opposite trends were observed among P patients, except for race. Over time, the odds of P decreased, while those of LR significantly increased (OR~adj~ 1.22 [1.16-1.29] for years 2007-2012 vs 1995-2000). Teaching hospitals were less likely to perform LR over L (OR~adj~ 0.82 [0.75-0.88]), while the opposite was true for hospitals with larger surgery volumes (OR~adj~ 1.07[1.03-1.11]). In-hospital complications were significantly less after LR than L (OR~adj~ 0.66 [0.62-0.69]), while in-hospital mortality was similar (OR~adj~ 0.93 [0.84-1.03]). In-hospital mortality was directly associated with age, length of stay, urgent/emergency admission, and inversely associated with female gender, private insurance, and surgery volumes. Figure 1
Conclusion:
There is a growing trend towards LR, which is still more likely to be performed in older patients with co-morbidities. In-hospital outcomes were affected by patients’ clinical and personal characteristics, and were better after LR than L or P.
