title: A case-mix model for monitoring of postoperative mortality after surgery for lung cancer.
abstract: BACKGROUND
  Postoperative mortality (POM) after surgery for lung cancer has been proposed as a performance indicator. Information on the size of the risk and its prognostic factors is needed to serve as a reference standard.
  
  
  METHODS
  Electronic records from the Rotterdam Cancer Registry (n=2337) and the Thames Cancer Registry (n=3772) were retrieved and analysed by sex, age, period, histology, region and extent of surgery. Multivariable logistic regression analysis was used to determine prognostic factors, to calculate odds ratios (OR) and to develop a case-mix model.
  
  
  RESULTS
  POM was 4.2% (n=257) on average and increased with age from 1.7% for patients younger than 60 years up to 9.4% for octogenarians. After lobectomy, POM was 2.9% against 6.0% and 9.5% after pneumonectomy left and right, respectively. Multivariable analysis showed higher risk for men (OR=1.4) and lower risk for adenocarcinoma (OR=0.6).
  
  
  CONCLUSIONS
  The final prediction model supports comparison and monitoring of POM rates for lung cancer. Only a limited number of risk factors need to be registered to allow adjustment for case-mix.
authors.affiliation: Rotterdam Cancer Registry, P.O. Box 289, 3000 AG Rotterdam, The Netherlands. damhuis@ikr.nl
authors.forename: Ronald
authors.initials: R
authors.lastname: Damhuis
authors.forename: Aman
authors.initials: A
authors.lastname: Coonar
authors.forename: Peter
authors.initials: P
authors.lastname: Plaisier
authors.forename: Marlies
authors.initials: M
authors.lastname: Dankers
authors.forename: Jos
authors.initials: J
authors.lastname: Bekkers
authors.forename: Karen
authors.initials: K
authors.lastname: Linklater
authors.forename: Henrik
authors.initials: H
authors.lastname: Møller
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011013:Pneumonectomy; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D020379:Risk Adjustment / Q000379:methods*; D017678:Sex Distribution; D015996:Survival Rate / Q000639:trends