Determining the optimal time to report mortality after lobectomy for lung cancer: An analysis of the time-varying risk of deathCentral MessagePerspective
Objective: Surgical mortality has traditionally been assessed at arbitrary intervals out to 1 year, without an agreed optimum time point. The aim of our study was to investigate the time-varying risk of death after lobectomy to determine the optimum period to evaluate surgical mortality rate after l...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | JTCVS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273623002231 |
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| author | Matthew Shiu Hang Wong Aina Pons, BSc, PGCert Paulo De Sousa, BSc, PgDip, RGN Chiara Proli, MD Simon Jordan, MB BCh, MD, FRCS Sofina Begum, MB ChB, MSc, FRCS Silviu Buderi, MB BCh, MSc, FRCSEd Vladimir Anikin, MD, FRCS Jonathan Finch, MBBS, FRCS Nizar Asadi, MD, FRCS Emma Beddow, MBBS, FRCS Eric Lim, MB ChB, MD, MSc, FRCS |
| author_facet | Matthew Shiu Hang Wong Aina Pons, BSc, PGCert Paulo De Sousa, BSc, PgDip, RGN Chiara Proli, MD Simon Jordan, MB BCh, MD, FRCS Sofina Begum, MB ChB, MSc, FRCS Silviu Buderi, MB BCh, MSc, FRCSEd Vladimir Anikin, MD, FRCS Jonathan Finch, MBBS, FRCS Nizar Asadi, MD, FRCS Emma Beddow, MBBS, FRCS Eric Lim, MB ChB, MD, MSc, FRCS |
| author_sort | Matthew Shiu Hang Wong |
| collection | DOAJ |
| description | Objective: Surgical mortality has traditionally been assessed at arbitrary intervals out to 1 year, without an agreed optimum time point. The aim of our study was to investigate the time-varying risk of death after lobectomy to determine the optimum period to evaluate surgical mortality rate after lobectomy for lung cancer. Methods: We performed a retrospective study of patients undergoing lobectomy for lung cancer at our institution from 2015 to 2022. Parametric survival models were assessed and compared with a nonparametric kernel estimate. The hazard function was plotted over time according to the best-fit statistical distribution. The time points at which instantaneous hazard rate peaked and stabilized in the 1-year period after surgery were then determined. Results: During the study period, 2284 patients underwent lobectomy for lung cancer. Cumulative mortality at 30, 90, and 180 days was 1.3%, 2.9%, and 4.9%, respectively. Log-logistic distribution showed the best fit compared with other statistical distribution, indicated by the lowest Akaike information criteria value. The instantaneous hazard rate was greatest during the immediate postoperative period (0.129; 95% confidence interval, 0.087-0.183) and diminishes rapidly within the first 30 days after surgery. Instantaneous hazard rate continued to decrease past 90 days and stabilized only at approximately 180 days. Conclusions: In-hospital mortality is the optimal follow-up period that captures the early-phase hazard during the immediate postoperative period after lobectomy. Thirty-day mortality is not synonymous to “early mortality,” as instantaneous hazard rate remains elevated well past the 90-day time point and only stabilizes at approximately 180 days after lobectomy. |
| first_indexed | 2024-03-08T21:48:11Z |
| format | Article |
| id | doaj.art-870d23ae318f4e0f83bde6d8db3da86c |
| institution | Directory Open Access Journal |
| issn | 2666-2736 |
| language | English |
| last_indexed | 2024-03-08T21:48:11Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj.art-870d23ae318f4e0f83bde6d8db3da86c2023-12-20T07:38:08ZengElsevierJTCVS Open2666-27362023-12-0116931937Determining the optimal time to report mortality after lobectomy for lung cancer: An analysis of the time-varying risk of deathCentral MessagePerspectiveMatthew Shiu Hang Wong0Aina Pons, BSc, PGCert1Paulo De Sousa, BSc, PgDip, RGN2Chiara Proli, MD3Simon Jordan, MB BCh, MD, FRCS4Sofina Begum, MB ChB, MSc, FRCS5Silviu Buderi, MB BCh, MSc, FRCSEd6Vladimir Anikin, MD, FRCS7Jonathan Finch, MBBS, FRCS8Nizar Asadi, MD, FRCS9Emma Beddow, MBBS, FRCS10Eric Lim, MB ChB, MD, MSc, FRCS11Academic Division of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom; Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomAcademic Division of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom; Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomAcademic Division of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom; Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomAcademic Division of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom; Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomDepartment of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomDepartment of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomDepartment of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomDepartment of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomDepartment of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomDepartment of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomDepartment of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United KingdomAcademic Division of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom; Department of Thoracic Surgery, Royal Brompton and Harefield Hospitals, London, United Kingdom; National Heart and Lung Institution, Imperial College London, London, United Kingdom; Address for reprints: Eric Lim, MB ChB, MD, MSc, FRCS, Academic Division of Thoracic Surgery, Royal Brompton Hospital, Sydney St, London, SW3 6NP, United Kingdom.Objective: Surgical mortality has traditionally been assessed at arbitrary intervals out to 1 year, without an agreed optimum time point. The aim of our study was to investigate the time-varying risk of death after lobectomy to determine the optimum period to evaluate surgical mortality rate after lobectomy for lung cancer. Methods: We performed a retrospective study of patients undergoing lobectomy for lung cancer at our institution from 2015 to 2022. Parametric survival models were assessed and compared with a nonparametric kernel estimate. The hazard function was plotted over time according to the best-fit statistical distribution. The time points at which instantaneous hazard rate peaked and stabilized in the 1-year period after surgery were then determined. Results: During the study period, 2284 patients underwent lobectomy for lung cancer. Cumulative mortality at 30, 90, and 180 days was 1.3%, 2.9%, and 4.9%, respectively. Log-logistic distribution showed the best fit compared with other statistical distribution, indicated by the lowest Akaike information criteria value. The instantaneous hazard rate was greatest during the immediate postoperative period (0.129; 95% confidence interval, 0.087-0.183) and diminishes rapidly within the first 30 days after surgery. Instantaneous hazard rate continued to decrease past 90 days and stabilized only at approximately 180 days. Conclusions: In-hospital mortality is the optimal follow-up period that captures the early-phase hazard during the immediate postoperative period after lobectomy. Thirty-day mortality is not synonymous to “early mortality,” as instantaneous hazard rate remains elevated well past the 90-day time point and only stabilizes at approximately 180 days after lobectomy.http://www.sciencedirect.com/science/article/pii/S2666273623002231hazard functionlobectomylung cancermortalityoutcomes analysis |
| spellingShingle | Matthew Shiu Hang Wong Aina Pons, BSc, PGCert Paulo De Sousa, BSc, PgDip, RGN Chiara Proli, MD Simon Jordan, MB BCh, MD, FRCS Sofina Begum, MB ChB, MSc, FRCS Silviu Buderi, MB BCh, MSc, FRCSEd Vladimir Anikin, MD, FRCS Jonathan Finch, MBBS, FRCS Nizar Asadi, MD, FRCS Emma Beddow, MBBS, FRCS Eric Lim, MB ChB, MD, MSc, FRCS Determining the optimal time to report mortality after lobectomy for lung cancer: An analysis of the time-varying risk of deathCentral MessagePerspective JTCVS Open hazard function lobectomy lung cancer mortality outcomes analysis |
| title | Determining the optimal time to report mortality after lobectomy for lung cancer: An analysis of the time-varying risk of deathCentral MessagePerspective |
| title_full | Determining the optimal time to report mortality after lobectomy for lung cancer: An analysis of the time-varying risk of deathCentral MessagePerspective |
| title_fullStr | Determining the optimal time to report mortality after lobectomy for lung cancer: An analysis of the time-varying risk of deathCentral MessagePerspective |
| title_full_unstemmed | Determining the optimal time to report mortality after lobectomy for lung cancer: An analysis of the time-varying risk of deathCentral MessagePerspective |
| title_short | Determining the optimal time to report mortality after lobectomy for lung cancer: An analysis of the time-varying risk of deathCentral MessagePerspective |
| title_sort | determining the optimal time to report mortality after lobectomy for lung cancer an analysis of the time varying risk of deathcentral messageperspective |
| topic | hazard function lobectomy lung cancer mortality outcomes analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2666273623002231 |
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