title: Impact of comorbidity index on morbidity and survival in non-small cell lung cancer.
abstract: BACKGROUND
  The number of surgeries in older patients with comorbidities is constantly growing. The present study examined the impact of comorbidity on postoperative complications and long-term survival in patients with completely resected non-small cell cancer.
  
  
  METHODS
  Between 2004 and 2008, 423 patients with non-small cell lung cancer underwent complete resection. A retrospective comparison of perioperative mortality, morbidity, Charlson comorbidity index (CCI), and postoperative length of hospital stay was performed.
  
  
  RESULTS
  The number of patients with CCI 0, 1-2, and ≥ 3 was 226, 170 and 27, respectively. The 5-year overall survival was 88% among patients with CCI 0, and 84% in those with CCI ≥ 1 (p = 0.05) in all pathological stages. The CCI 0 group had significantly better overall survival than CCI 0 group and 30 (15%) in the CCI ≥ 1 group (p = 0.024). Length of stay was shorter in the CCI 0 group (11 ± 5 days) than in the CCI ≥ 1 group (15 ± 19 days, p = 0.015).
  
  
  CONCLUSIONS
  A high CCI correlated with higher postoperative morbidity and longer length of stay. We identified better a prognosis in patients with CCI 0 compared to those with CCI 1-2.
authors.affiliation: Section of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Sotaro
authors.initials: S
authors.lastname: Otake
authors.affiliation: Section of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan ohtsuka@a3.keio.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohtsuka
authors.affiliation: Section of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Asakura
authors.affiliation: Section of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Kamiyama
authors.affiliation: Section of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Mitsutomo
authors.initials: M
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Carcinoma; Comorbidity; Health status indicators; Lung neoplasms; Survival analysis; non-small cell lung cancer