Background

This study analysed the predictors of 30 day postoperative mortality following lung cancer resection in Queensland, the third most populous state in Australia.

Methods

Data on all Queensland residents diagnosed with non-small cell lung cancer (NSCLC) between 2001 and 2011 and who subsequently underwent surgery for lung cancer was obtained from the Queensland Oncology Repository. Thirty day postoperative mortality was modelled using multivariate Cox proportional hazards regression controlling for annual surgical volume of hospital, gender, age, remoteness of residence, socioeconomic status, anaesthetic score, comorbidity and surgery in a public facility.

Results

A total of 2,857 NSCLC patients who underwent resection for lung cancer in 17 hospitals across the state were included in the analysis; the median age was 67 years and 61% were males.

Overall crude 30-day mortality was 1.7%.  In multivariate modelling, independent predictors of death within 30 days of lung cancer surgery included male gender (HR 2.7, 95% confidence interval [CI] 1.3-5.9, p=0.011), presence of one or more comorbidities (HR 2.5, CI 1.3-4.7, p=0.005) and low surgical volume of hospital (<27/yr, HR 2.2, CI 1.0-4.6, p=0.042).  Age, remoteness of residence, socioeconomic status, anaesthetic score and surgery in a public facility were non-significant factors in the model.

Conclusions

Demographic and clinical patient characteristics, along with surgical volume of hospital are significant prognostic factors for 30 day postoperative mortality following lung cancer surgery.  This study suggests that socioeconomic status and remoteness of residence do not influence the quality of surgical care for lung cancer in Queensland.