Objective: In elderly patients with lung cancer, the presumed fear of postoperative complications has resulted in the delivery of limited resection. Surgical decision-making for such patients would become easier if clinicians could predict who is at high risk of postoperative complications. The purpose of this study is to propose a scoring system to predict the risk of postoperative complications for elderly patients with lung cancer.
Methods: We reviewed patients aged 75 years or older who underwent lobectomy for lung cancer at a single hospital (n = 199). A multivariable logistic regression model was utilized to determine risk factors for postoperative complications.
Results: Six risk factors for postoperative complications were identified, and we derived a risk score by assigning weights to these factors based on their odds ratios, as follows: Risk score = 7 × (performance status of 2) + 6 × (coronary artery disease) + 3 × (a history of cerebrovascular accident) + 2 × (restrictive ventilatory impairment) + 1 × (male sex) + 1 × (interstitial pneumonia). The postoperative complication rates in patients with risk scores of 0, 1-2, 3-5, 6-8, and 9-14 were 19, 29, 56, 68, and 90%, respectively.
Conclusions: The proposed risk score was able to predict the incidence of postoperative complications. The risk score can be used to identify high-risk patients and to select proper treatment strategies.
Keywords: Elderly patients; Lobectomy; Lung cancer; Postoperative complications; Risk score.