[Risk factors in bronchogenic carcinoma surgery].
OBJECTIVE
To analyze the factors that determine the risk of morbidity and mortality associated with lung resection in patients with bronchogenic carcinoma.


METHODS
Prospective multicenter study conducted between October 1, 1993 and September 30, 1997 in the 19 hospitals that make up the Bronchogenic Carcinoma Cooperative Group. During the study period, 2994 patients with bronchogenic carcinoma underwent surgery. The morbidity and mortality data at 30 days from all centers were recorded in a single registry.


RESULTS
Major resection was performed in 2491 patients, whereas 212 underwent minor resection. The resection had to be extended in 296 and exploratory thoracotomy was carried out in 291. Postoperative complications were reported in 1057 patients (35.2%). Complications directly related to surgery were the most common (22.9%), followed by respiratory (19.5%) and cardiovascular (10.7%) complications. Of the patients with complications, 654 patients (21.8%) had only 1, whereas 403 (13.4%) had more than 1. After classification of complications, 21% were found to be minor and 14.2% were major. Mortality at 30 days was 6.8% (204 patients), and strongly linked to the presentation of major complications--40.8% of those with such complications died.


CONCLUSIONS
Surgical treatment of bronchogenic carcinoma in Spain is associated with high morbidity and mortality. The morbidity reported in the present study lies in the middle of the ranges found in the literature, whereas mortality lies at the high end of the range. The presence of major complications and/or multiple complications should be considered as strong risk factors.
Duque
José Luis
JL
Servicio de Cirugía Torácica, Hospital Universitario, Valladolid, España. jduque@hcuv.sacyl.es
Rami-Porta
Ramón
R
Almaraz
Ana
A
Castanedo
Manuel
M
Freixinet
Jorge
J
Fernández de Rota
Antonio
A
López Encuentra
Angel
A
D000368:Aged; D000369:Aged, 80 and over; D002283:Carcinoma, Bronchogenic / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality; D009203:Myocardial Infarction / Q000401:mortality; D011013:Pneumonectomy / Q000401:mortality / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000401:mortality; D012120:Respiration Disorders / Q000453:epidemiology; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013908:Thoracotomy / Q000401:mortality / Q000706:statistics & numerical data