title: Simplified comorbidity score for elderly patients undergoing thoracoscopic surgery for lung cancer.
abstract: OBJECTIVE
  We investigated the efficiency of the Simplified Comorbidity Score (SCS) for predicting postoperative complications and prognosis in elderly patients undergoing video-assisted thoracoscopic surgery (VATS) for lung cancer.
  
  
  METHODS
  We reviewed 216 patients aged 75 years or older, who underwent pulmonary resection by VATS for lung cancer between January, 2005 and December, 2012. The SCS assigns different scores to patients' comorbidities; namely, smoking (n = 7); diabetes mellitus (n = 5); renal insufficiency (n = 4); and respiratory, neoplastic, and cardiovascular comorbidities or alcoholism (n = 1 each). Patients were divided into a high SCS group (SCS ≥ 9; n = 154) and a low SCS group (<9; n = 62), for a comparative analysis of differences in perioperative factors and prognoses.
  
  
  RESULTS
  Limited resection was more frequent in the high SCS group (58 %) than in the low SCS group (40 %; P = 0.02). Postoperative complications were more frequent in the high SCS group (45 %) than in the low SCS group (15 %; P < 0.01). A logistic regression analysis revealed that a high SCS was significantly predictive of postoperative complications (odds ratio 2.7; P = 0.02). The 5-year overall survival rate was 79 % for the low SCS group and 52 % for the high SCS group (P < 0.01).
  
  
  CONCLUSIONS
  The SCS can predict the likelihood of postoperative complications and prognosis of elderly patients with VATS-treated lung cancers.
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. tomohiroh@med.tottori-u.ac.jp.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Haruki
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Yurugi
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Wakahara
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsuoka
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Miwa
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Kunio
authors.initials: K
authors.lastname: Araki
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Taniguchi
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005544:Forecasting; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D051437:Renal Insufficiency / Q000453:epidemiology; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D020775:Thoracic Surgery, Video-Assisted
keywords: Complication; Elderly patient; Lung cancer; Prognosis; Video-assisted thoracoscopic surgery