Validation of the Charlson comorbidity index in patients with operated primary non-small cell lung cancer

• Published in: European journal of cardio-thoracic surgery Vol. 23; no. 1; pp. 30 - 34
• Main Authors: Birim, Ö., Maat, A.P.W.M., Kappetein, A.P., van Meerbeeck, J.P., Damhuis, R.A.M., Bogers, A.J.J.C.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 01-01-2003; Elsevier Science
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - surgery; Charlson comorbidity index; Female; Hospital Mortality; Humans; Lung cancer; Lung Neoplasms - mortality; Lung Neoplasms - surgery; Male; Medical sciences; Middle Aged; Morbidity; Mortality; Multivariate Analysis; Pneumology; Prognosis; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - mortality; Retrospective Studies; Risk Factors; Severity of Illness Index; Sex; Surgery; Tumors of the respiratory system and mediastinum; Lung cancer; Mortality; Surgery; Charlson comorbidity index; Morbidity; Human; Validation; Lung disease; Prognosis; Respiratory disease; Index; Malignant tumor; Bronchopulmonary; Primitive; Treatment; Bronchus disease; Non small cell carcinoma
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(02)00721-2

Objective: To validate the influence of the Charlson comorbidity index (CCI) in patients with operated primary non-small cell lung cancer. Methods: From January 1996 to December 2001, 205 consecutive resections for non-small cell lung cancer were performed at the Erasmus Medical Center Rotterdam. The patients ranged in age from 29 to 82 years, with a mean age of 64 years. In a retrospective study, each patient was scaled according to the CCI and the complications of surgery were determined. Results: The hospital mortality was 2.4% (5/205). Of the 205 patients 167 (32.7%) experienced minor complications and 32 (15.6%) major complications. In univariate analysis, gender, grades 3–4 of the CCI, any prior tumor treated in the last 5 years and chronic pulmonary disease were significant predictors of adverse outcome. Multivariate analysis showed that only grades 3–4 of the CCI was predictive (odds ratio=9.8; 95% confidence interval=2.1–45.9). Although only comorbidity grades 3–4 was a significant predictor, for every increase of the comorbidity grade the relative risk of adverse outcome showed a slight increase. Conclusion: The CCI is strongly correlated with higher risk of surgery in primary non-small cell lung cancer patients and is a better predictor than individual risk factors.