Tomizawa Kenji, Usami Noriyasu, Fukumoto Koichi, Sakakura Noriaki, Fukui Takayuki, Ito Simon, Hatooka Shunzo, Kuwano Hiroyuki, Mitsudomi Tetsuya, Sakao Yukinori
Department of Thoracic Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
Gen Thorac Cardiovasc Surg. 2014 May;62(5):308-13. doi: 10.1007/s11748-014-0375-0. Epub 2014 Feb 13.
Although 30-day mortality rate is adapted to evaluate perioperative mortality after surgery, whether 90-day mortality rate adequately evaluates perioperative mortality remains unknown. Therefore, we analyzed 30- and 90-day mortality rates after pulmonary resection in patients with primary lung cancer.
A total of 2207 pulmonary resections for primary lung cancer performed between 1996 and 2010 at the Aichi Cancer Center Hospital were analyzed and divided into two groups of almost equal number: the early period group (1070 patients, 1996-2004) and the late period group (1137 patients, 2005-2010). Sixty-six and 34 patients died within a year during the early and late periods, respectively. The causes of death (recurrence, bleeding, sudden death, respiratory failure, and adverse event of chemotherapy), and 30- and 90-day mortality rates were investigated.
The 30-/90-day mortality rates in the early and late period groups were 0.56/0.75 and 0.35/0.79 %, respectively. The postoperative survival days of 75 patients who died from recurrence within 1 year after pulmonary resection and 7 patients from bleeding or sudden death were more than 91 days and <30 days, respectively. The median postoperative survival of patients who died from respiratory failure was 67 days (range 20-142 days) in the early period and 100 days (range 47-149 days) in the late period. In the late period, it was difficult to assess perioperative mortality of pulmonary complications with 30-day mortality.
A risk assessment of perioperative mortality after pulmonary resection should be performed using the 30- and 90-day mortality.
虽然30天死亡率适用于评估手术后的围手术期死亡率，但90天死亡率是否能充分评估围手术期死亡率仍不清楚。因此，我们分析了原发性肺癌患者肺切除术后的30天和90天死亡率。
对1996年至2010年期间在爱知县癌症中心医院进行的2207例原发性肺癌肺切除术进行分析，并分为两组，数量大致相等：早期组（1070例患者，1996 - 2004年）和晚期组（1137例患者，2005 - 2010年）。早期和晚期分别有66例和34例患者在1年内死亡。调查死亡原因（复发、出血、猝死、呼吸衰竭和化疗不良事件）以及30天和90天死亡率。
早期组和晚期组的30天/90天死亡率分别为0.56%/0.75%和0.35%/0.79%。肺切除术后1年内因复发死亡的75例患者和因出血或猝死死亡的7例患者的术后生存天数分别超过91天和<30天。因呼吸衰竭死亡的患者术后中位生存期在早期为67天（范围20 - 142天），在晚期为100天（范围47 - 149天）。在晚期，用30天死亡率难以评估肺部并发症的围手术期死亡率。
应使用30天和90天死亡率对肺切除术后的围手术期死亡率进行风险评估。
