Comparison of Lung Cancer Surgery Outcomes in Queensland for Indigenous and Nonindigenous Australians
Introduction: Indigenous Australians (Aboriginal and Torres Strait Islander) have lower overall survival from lung cancer compared with nonindigenous Australians. Indigenous Australians receive higher rates of chemotherapy and/or radiotherapy. The equity of peri-operative care and thoracic surgical...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364323001108 |
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| author | Frazer Kirk, M.B.B.S., MSurg Syed Danial Syed Ahmad, BMedSc Clayton Lam, MD, BMedSc, GradCertPubHlt Matthew S. Yong, M.B.B.S., PhD, FRACS Cheng He, M.B.B.S., BMedSc, FRACS Sumit Yadav, M.B.B.S., MS MCh C/Th, FRACS Wing Lo, M.B.B.S., PhD, FRACS Christopher Cole, BA, M.B.B.S., FRACS Morgan Windsor, BMedSci, M.B.B.S.(Hons), FRACS Rishendran Naidoo, MBCHB, MMed, FRACS Andrie Stroebel, MBChB, MMed, FRACS |
| author_facet | Frazer Kirk, M.B.B.S., MSurg Syed Danial Syed Ahmad, BMedSc Clayton Lam, MD, BMedSc, GradCertPubHlt Matthew S. Yong, M.B.B.S., PhD, FRACS Cheng He, M.B.B.S., BMedSc, FRACS Sumit Yadav, M.B.B.S., MS MCh C/Th, FRACS Wing Lo, M.B.B.S., PhD, FRACS Christopher Cole, BA, M.B.B.S., FRACS Morgan Windsor, BMedSci, M.B.B.S.(Hons), FRACS Rishendran Naidoo, MBCHB, MMed, FRACS Andrie Stroebel, MBChB, MMed, FRACS |
| author_sort | Frazer Kirk, M.B.B.S., MSurg |
| collection | DOAJ |
| description | Introduction: Indigenous Australians (Aboriginal and Torres Strait Islander) have lower overall survival from lung cancer compared with nonindigenous Australians. Indigenous Australians receive higher rates of chemotherapy and/or radiotherapy. The equity of peri-operative care and thoracic surgical outcomes in Australian indigenous populations have not been contemporarily evaluated. Methods: We performed a retrospective registry analysis of the Queensland Cardiac Outcomes Registry Thoracic Database evaluating all adult lung cancer resections across Queensland from January 1, 2016 to April 20, 2022. Evaluating the time from diagnosis to surgery, operative data, and postoperative morbidity and mortality comparing Aboriginal and/or Torres Strait Islander people with nonindigenous Australians. Results: There were 31 patients (2.56%) of 1208 who identified as indigenous. The mean age at surgery was 68.2 years versus 66 years in the indigenous and nonindigenous, respectively (p = 0.23). There was female predominance among indigenous patients (n = 28, 90.32%, p < 0.01) and the average body mass index was lower (22.52 versus 27.09, p < 0.01). There was no variation in the surgical parameters or histopathologic distribution of cancer type between groups. Multivariable logistic regression analysis suggested that indigenous patients were at elevated risk of blood transfusion (relative risk 3.9, p = 0.014, OR = 9.01, 95% confidence interval [CI]: 2.25–36.33, p < 0.01) and had greater transfusion requirements (risk ratio 4.08, p = 0.0116 and OR = 12.67, 95% CI: 2.25–71.49, p < 0.01); however, the influence of low absolute number of transfusions must be acknowledged here. Indigenous status was not associated with increased intensive care unit admission (OR = 1.79, 95% CI: 0.17–18.80, p = 0.62), return to operating theater (OR = 2.1, 95% CI: 0.24–18.15, p = 0.50), new atrial fibrillation (OR = 0.52, 95% CI: 0.07–4.01, p = 0.55), prolonged air leak (OR = 0.29, 95% CI: 0.04– 2.16, p = 0.228), or pneumonia postoperatively (OR = 4.77, 95% CI: 0.55–41.71, p = 0.16). With only three deaths, no meaningful trends were observed. Time from diagnosis to surgery was comparable in the indigenous and nonindigenous groups (88.6 d, 95% CI: 54.26–123.24 versus 86.2 d, 81.40–91.02, p = 0.87). Postoperative length of stay was not numerically or statistically different between groups. (indigenous 7.54 d versus nonindigenous 7.13 d, p = 0.90). Conclusions: Indigenous patients are more likely to receive a blood transfusion than nonindigenous patients during lung resection. Reassuringly, the perioperative care provided to indigenous Australians undergoing lung resection in Queensland seems to be comparable to that of the nonindigenous population. |
| first_indexed | 2024-03-11T17:02:55Z |
| format | Article |
| id | doaj.art-0bb3b90bbd4a481eaec4a2c96f0346d0 |
| institution | Directory Open Access Journal |
| issn | 2666-3643 |
| language | English |
| last_indexed | 2024-03-11T17:02:55Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj.art-0bb3b90bbd4a481eaec4a2c96f0346d02023-10-20T06:48:44ZengElsevierJTO Clinical and Research Reports2666-36432023-10-01410100567Comparison of Lung Cancer Surgery Outcomes in Queensland for Indigenous and Nonindigenous AustraliansFrazer Kirk, M.B.B.S., MSurg0Syed Danial Syed Ahmad, BMedSc1Clayton Lam, MD, BMedSc, GradCertPubHlt2Matthew S. Yong, M.B.B.S., PhD, FRACS3Cheng He, M.B.B.S., BMedSc, FRACS4Sumit Yadav, M.B.B.S., MS MCh C/Th, FRACS5Wing Lo, M.B.B.S., PhD, FRACS6Christopher Cole, BA, M.B.B.S., FRACS7Morgan Windsor, BMedSci, M.B.B.S.(Hons), FRACS8Rishendran Naidoo, MBCHB, MMed, FRACS9Andrie Stroebel, MBChB, MMed, FRACS10Department of Cardiothoracic Surgery, Gold Coast University Hospital, Southport, Queensland, Australia; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia; School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; Corresponding author. Address for correspondence: Frazer Kirk, M.B.B.S., MSurg, Department of Cardiothoracic Surgery, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD 4215, Australia.Department of Cardiothoracic Surgery, Gold Coast University Hospital, Southport, Queensland, Australia; Department of Cardiothoracic Surgery, Princess Alexandria Hospital, Brisbane, Queensland, AustraliaSchool of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia; Department of Vascular Surgery, Gold Coast University Hospital, Southport, Queensland, AustraliaDepartment of Cardiothoracic Surgery, Gold Coast University Hospital, Southport, Queensland, Australia; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, AustraliaDepartment of Cardiothoracic Surgery, Gold Coast University Hospital, Southport, Queensland, Australia; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, AustraliaDepartment of Cardiothoracic Surgery, The Townsville University Hospital, Townsville, Queensland, AustraliaDepartment of Cardiothoracic Surgery, Princess Alexandria Hospital, Brisbane, Queensland, AustraliaDepartment of Cardiothoracic Surgery, Princess Alexandria Hospital, Brisbane, Queensland, AustraliaDepartment of Thoracic Surgery, Royal Brisbane Women’s Hospital, Brisbane, Queensland, Australia; Department of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Queensland, AustraliaDepartment of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Queensland, AustraliaDepartment of Cardiothoracic Surgery, Gold Coast University Hospital, Southport, Queensland, AustraliaIntroduction: Indigenous Australians (Aboriginal and Torres Strait Islander) have lower overall survival from lung cancer compared with nonindigenous Australians. Indigenous Australians receive higher rates of chemotherapy and/or radiotherapy. The equity of peri-operative care and thoracic surgical outcomes in Australian indigenous populations have not been contemporarily evaluated. Methods: We performed a retrospective registry analysis of the Queensland Cardiac Outcomes Registry Thoracic Database evaluating all adult lung cancer resections across Queensland from January 1, 2016 to April 20, 2022. Evaluating the time from diagnosis to surgery, operative data, and postoperative morbidity and mortality comparing Aboriginal and/or Torres Strait Islander people with nonindigenous Australians. Results: There were 31 patients (2.56%) of 1208 who identified as indigenous. The mean age at surgery was 68.2 years versus 66 years in the indigenous and nonindigenous, respectively (p = 0.23). There was female predominance among indigenous patients (n = 28, 90.32%, p < 0.01) and the average body mass index was lower (22.52 versus 27.09, p < 0.01). There was no variation in the surgical parameters or histopathologic distribution of cancer type between groups. Multivariable logistic regression analysis suggested that indigenous patients were at elevated risk of blood transfusion (relative risk 3.9, p = 0.014, OR = 9.01, 95% confidence interval [CI]: 2.25–36.33, p < 0.01) and had greater transfusion requirements (risk ratio 4.08, p = 0.0116 and OR = 12.67, 95% CI: 2.25–71.49, p < 0.01); however, the influence of low absolute number of transfusions must be acknowledged here. Indigenous status was not associated with increased intensive care unit admission (OR = 1.79, 95% CI: 0.17–18.80, p = 0.62), return to operating theater (OR = 2.1, 95% CI: 0.24–18.15, p = 0.50), new atrial fibrillation (OR = 0.52, 95% CI: 0.07–4.01, p = 0.55), prolonged air leak (OR = 0.29, 95% CI: 0.04– 2.16, p = 0.228), or pneumonia postoperatively (OR = 4.77, 95% CI: 0.55–41.71, p = 0.16). With only three deaths, no meaningful trends were observed. Time from diagnosis to surgery was comparable in the indigenous and nonindigenous groups (88.6 d, 95% CI: 54.26–123.24 versus 86.2 d, 81.40–91.02, p = 0.87). Postoperative length of stay was not numerically or statistically different between groups. (indigenous 7.54 d versus nonindigenous 7.13 d, p = 0.90). Conclusions: Indigenous patients are more likely to receive a blood transfusion than nonindigenous patients during lung resection. Reassuringly, the perioperative care provided to indigenous Australians undergoing lung resection in Queensland seems to be comparable to that of the nonindigenous population.http://www.sciencedirect.com/science/article/pii/S2666364323001108Lung CancerSurgeryLobectomyIndigenousAustralianAboriginal |
| spellingShingle | Frazer Kirk, M.B.B.S., MSurg Syed Danial Syed Ahmad, BMedSc Clayton Lam, MD, BMedSc, GradCertPubHlt Matthew S. Yong, M.B.B.S., PhD, FRACS Cheng He, M.B.B.S., BMedSc, FRACS Sumit Yadav, M.B.B.S., MS MCh C/Th, FRACS Wing Lo, M.B.B.S., PhD, FRACS Christopher Cole, BA, M.B.B.S., FRACS Morgan Windsor, BMedSci, M.B.B.S.(Hons), FRACS Rishendran Naidoo, MBCHB, MMed, FRACS Andrie Stroebel, MBChB, MMed, FRACS Comparison of Lung Cancer Surgery Outcomes in Queensland for Indigenous and Nonindigenous Australians JTO Clinical and Research Reports Lung Cancer Surgery Lobectomy Indigenous Australian Aboriginal |
| title | Comparison of Lung Cancer Surgery Outcomes in Queensland for Indigenous and Nonindigenous Australians |
| title_full | Comparison of Lung Cancer Surgery Outcomes in Queensland for Indigenous and Nonindigenous Australians |
| title_fullStr | Comparison of Lung Cancer Surgery Outcomes in Queensland for Indigenous and Nonindigenous Australians |
| title_full_unstemmed | Comparison of Lung Cancer Surgery Outcomes in Queensland for Indigenous and Nonindigenous Australians |
| title_short | Comparison of Lung Cancer Surgery Outcomes in Queensland for Indigenous and Nonindigenous Australians |
| title_sort | comparison of lung cancer surgery outcomes in queensland for indigenous and nonindigenous australians |
| topic | Lung Cancer Surgery Lobectomy Indigenous Australian Aboriginal |
| url | http://www.sciencedirect.com/science/article/pii/S2666364323001108 |
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