Can we predict postoperative complications in octogenarians undergoing lung resection?

Area of Science:

• Thoracic surgery
• Geriatric medicine
• Surgical oncology

Background:

• Predicting postoperative complications in octogenarians undergoing lung resection is challenging.
• Identifying reliable predictive parameters is essential for optimizing patient care and surgical outcomes.

Purpose of the Study:

• To determine predictive parameters for postoperative complications in octogenarian patients (≥80 years) undergoing lung resection.
• To evaluate the efficacy of various predictive indices and scores in this patient population.

Main Methods:

• Retrospective analysis of 49 octogenarian patients who underwent lung resection.
• Calculation of patient demographics, operative parameters, and predictive scores (CCI, SCI, ASA, GPS, ARISCAT, POSSUM).
• Complications recorded using Clavien-Dindo classification.

Main Results:

• Higher ARISCAT and POSSUM scores were significantly associated with increased postoperative complications (p<0.001).
• Sublobar resection showed fewer complications than lobar resection (38.9% vs. 76.9%, p=0.019).
• ARISCAT and POSSUM scores remained independent predictors in multivariate analysis.

Conclusions:

• Higher ARISCAT and POSSUM scores are promising adjuncts for risk stratification in octogenarian lung resection patients.
• Validation in larger, prospective, multicenter studies is recommended before clinical application.
• These scores can potentially aid in patient selection for lung resection.