Authors: Nicastri DG, Alpert N, Liu B, Wolf A, Taioli E, Tran BV, Flores R
Title: Oxygen Use After Lung Cancer Surgery.
Journal: Ann Thorac Surg 106(5):1548-1555
Date: 2018 Nov
PubMed ID: 29928852
Abstract: BACKGROUND: There are no published reports on predictors of oxygen (O2) use after lung cancer surgery. The prospect of O2 use after lung cancer surgery may affect a patient's therapy choice. METHODS: The Surveillance, Epidemiology, and End Results (SEER)-Medicare data set was queried to identify patients diagnosed with primary lung cancer (stage I/II) who underwent surgical resection from 1994 to 2010. Patients with a second resection within 6 months of their first and those with preoperative O2 use were excluded. Multivariable logistic regression was performed to evaluate the odds ratios and 95% confidence intervals of O2 use (defined as being billed for home O2) after discharge for lung cancer surgery. RESULTS: Of 21,245 eligible patients from 1994 to 2010, 3,255 (15.3%) were billed for O2 use in the first month of discharge. Of these, 13.7% (447 of 3,255) stopped using within 1 month, and 1.47% died. By 6 months, an additional 6.7% died, and 46.27% (1,384 of 2,991) were still alive and using O2. Discharge on O2 was associated with higher odds of death within 6 months (odds ratio, 1.35; 95% confidence interval, 1.17 to 1.55). The significant, independent risk factors for O2 use at discharge were procedure, sex, race, histology, pulmonary comorbidities, obesity, length of stay, pulmonary complications, and discharge mode. CONCLUSIONS: Home O2 use after lung cancer surgery comprises a sizable portion of this population and is correlated with death in the first 6 months. Various predictors significantly increased the risk of O2 use at discharge. However, 49.3% of those originally discharged on O2 were alive and off O2 at 6 months.