title: Postoperative complications in elderly patients after lung cancer surgery.
abstract: OBJECTIVE
  The purpose of this study was to identify the risk factors for postoperative complications in elderly patients undergoing lung cancer surgery. These complications remain higher in elderly patients than in young patients, and decreasing their incidence is an important goal. We investigated surgical factors in particular, including surgical time, blood loss and thoracotomy length.
  
  
  METHODS
  Between January 2000 and September 2009, 567 patients underwent lung cancer surgery at our institution. We retrospectively reviewed the records of 119 patients who underwent lobectomy, aged 75 years or older, for possible postoperative complication risk factors.
  
  
  RESULTS
  The patients' median age was 77 years (range, 75-88 years); there were 79 men and 40 women. There were no perioperative or postoperative deaths. Postoperative complications developed in 41 (34.5%) patients, including 17 (14.3%) with arrhythmia, 10 (8.4%) with prolonged air leak, 10 (8.4%) with delirium, 8 (6.7%) with pneumonia, 4 (3.4%) with hypoxia, 2 (1.7%) with cerebrovascular disease and 1 (0.8%) with postoperative haemorrhage. Univariate analysis showed that the risk factors for postoperative complications consisted of longer surgery time (P = 0.002), blood loss (P = 0.021) and undergoing surgery prior to May 2004 (P = 0.002). Multivariate analysis revealed that surgery time (P = 0.041) and surgery prior to May 2004 (P = 0.008) were independent risk factors for postoperative complications.
  
  
  CONCLUSIONS
  This study demonstrates that the quality of surgery is an important factor in determining the risk of postoperative complications. Severe adhesions and lung inflammation are conditions that make lung cancer surgery difficult; a skillful and meticulous surgical technique is required in elderly patients.
authors: Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan. sshiono@ypch.gr.jp
authors: Satoshi
authors: S
authors: Shiono
authors: Masami
authors: M
authors: Abiko
authors: Toru
authors: T
authors: Sato
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011013:Pneumonectomy / Q000009:adverse effects* / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013908:Thoracotomy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
keywords: Elderly patients; Lung cancer; Surgery