Abstract
Dementia is a common medical disorder and many surgical procedures carry a higher risk of complications in dementia patients. The aim of this retrospective study is to evaluate the operative results and prognosis of lung cancer patients with dementia. In this study, 9 consecutive patients with dementia who were diagnosed with lung cancer and underwent an anatomic lung resection between January 2016 and January 2021 were assessed retrospectively. The data included age, gender, duration of treatment for dementia, comorbid diseases, body mass index, symptoms, smoking status, respiratory function test results, localization of the tumor, methods used for preoperative tissue diagnosis, histopathological cell type, American Society of Anesthesiologists physical status classification scores, type of surgical resection, pathological stage, postoperative complications, postoperative tracheostomy, postoperative intensive care, length of the clinic and overall hospital stay, mortality rate, total cost, and length of patient follow-up. All patients in this study had several serious comorbid diseases and high body mass index. Delirium and cognitive function impairment were found in 2/3 of the patients in the postoperative period. All patients developed postoperative respiration-associated complications and extended periods of hospital stay. The mean total hospital cost of the patients was 2.5 times the normal. Finally, the mortality rate was 45%. The lung cancer surgery on dementia patients should be carefully considered because of poor surgical outcomes including increased severe and multiple postoperative complications such as pulmonary complications and delirium, long hospitalization time, and high mortality rates.
Keywords
Ethical Statement
This study protocol was reviewed and approved by Karadeniz Technical University Faculty of Medicine Scientific Research Ethics Committee and approval number 2021/385.
Supporting Institution
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Thanks
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References
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- Xie Z, Tanzi RE. Alzheimer's disease and post-operative cognitive dysfunction. Exp Gerontol. 2006;41(4):346-59.
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- Masutani R, Pawar A, Lee H, Weissman JS, Kim DH. Outcomes of Common Major Surgical Procedures in Older Adults With and Without Dementia. JAMA Netw Open. 2020;3(7):e2010395.
- Mehaffey JH, Hawkins RB, Tracci MC, Robinson WP, Cherry KJ, Kern JA et al. Preoperative dementia is associated with increased cost and complications after vascular surgery. J Vasc Surg. 2018;68(4):1203-1208.
- Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911-22.
- Gleason LJ, Schmitt EM, Kosar CM, Tabloski P, Saczynski JS, Robinson T, et al. Effect of Delirium and Other Major Complications on Outcomes After Elective Surgery in Older Adults. JAMA Surg. 2015;150(12):1134-40.
- Robinson TN, Wu DS, Pointer LF, Dunn CL, Moss M. Preoperative cognitive dysfunction is related to adverse postoperative outcomes in the elderly. J Am Coll Surg. 2012;215(1):12-7; discussion 17-8.
- Baroni M, Serra R, Boccardi V, Ercolani S, Zengarini E, Casucci P, et al. The orthogeriatric comanagement improves clinical outcomes of hip fracture in older adults. Osteoporos Int. 2019;30(4):907-916.
- Edelstein DM, Aharonoff GB, Karp A, Capla EL, Zuckerman JD, Koval KJ, et al. Effect of postoperative delirium on outcome after hip fracture. Clin Orthop Relat Res. 2004 ;(422):195-200.
- Baker NL, Cook MN, Arrighi HM, Bullock R. Hip fracture risk and subsequent mortality among Alzheimer's disease patients in the United Kingdom, 1988-2007. Age Ageing. 2011;40(1):49-54.
- Ali K, Sakowitz S, Chervu NL, Verma A, Bakhtiyar SS, Curry J, et al. Association of dementia with clinical and financial outcomes following lobectomy for lung cancer. JTCVS Open. 2023;16:965-975.
Abstract
References
- Sosa-Ortiz AL, Acosta-Castillo I, Prince MJ. Epidemiology of dementias and Alzheimer's disease. Arch Med Res. 2012;43(8):600-8.
- Xie Z, Tanzi RE. Alzheimer's disease and post-operative cognitive dysfunction. Exp Gerontol. 2006;41(4):346-59.
- Hu CJ, Liao CC, Chang CC, Wu CH, Chen TL. Postoperative adverse outcomes in surgical patients with dementia: a retrospective cohort study. World J Surg. 2012;36(9):2051-8.
- Crinò L, Weder W, van Meerbeeck J, Felip E; ESMO Guidelines Working Group. Early stage and locally avanced (non-metastatic) non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010 ;21 Suppl 5:v103-15.
- Eckenhoff RG, Laudansky KF. Anesthesia, surgery, illness and Alzheimer's disease. Prog Neuropsychopharmacol Biol Psychiatry. 2013;47:162-6.
- Kassahun WT. The effects of pre-existing dementia on surgical outcomes in emergent and nonemergent general surgical procedures: assessing differences in surgical risk with dementia. BMC Geriatr. 2018;18(1):153.
- Masutani R, Pawar A, Lee H, Weissman JS, Kim DH. Outcomes of Common Major Surgical Procedures in Older Adults With and Without Dementia. JAMA Netw Open. 2020;3(7):e2010395.
- Mehaffey JH, Hawkins RB, Tracci MC, Robinson WP, Cherry KJ, Kern JA et al. Preoperative dementia is associated with increased cost and complications after vascular surgery. J Vasc Surg. 2018;68(4):1203-1208.
- Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911-22.
- Gleason LJ, Schmitt EM, Kosar CM, Tabloski P, Saczynski JS, Robinson T, et al. Effect of Delirium and Other Major Complications on Outcomes After Elective Surgery in Older Adults. JAMA Surg. 2015;150(12):1134-40.
- Robinson TN, Wu DS, Pointer LF, Dunn CL, Moss M. Preoperative cognitive dysfunction is related to adverse postoperative outcomes in the elderly. J Am Coll Surg. 2012;215(1):12-7; discussion 17-8.
- Baroni M, Serra R, Boccardi V, Ercolani S, Zengarini E, Casucci P, et al. The orthogeriatric comanagement improves clinical outcomes of hip fracture in older adults. Osteoporos Int. 2019;30(4):907-916.
- Edelstein DM, Aharonoff GB, Karp A, Capla EL, Zuckerman JD, Koval KJ, et al. Effect of postoperative delirium on outcome after hip fracture. Clin Orthop Relat Res. 2004 ;(422):195-200.
- Baker NL, Cook MN, Arrighi HM, Bullock R. Hip fracture risk and subsequent mortality among Alzheimer's disease patients in the United Kingdom, 1988-2007. Age Ageing. 2011;40(1):49-54.
- Ali K, Sakowitz S, Chervu NL, Verma A, Bakhtiyar SS, Curry J, et al. Association of dementia with clinical and financial outcomes following lobectomy for lung cancer. JTCVS Open. 2023;16:965-975.
Details
| Primary Language | English |
|---|---|
| Subjects | Thoracic Surgery |
| Journal Section | Research Article |
| Authors | |
| Publication Date | March 29, 2024 |
| Submission Date | November 7, 2023 |
| Acceptance Date | March 14, 2024 |
| Published in Issue | Year 2024 Volume: 41 Issue: 1 |
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