Association of dementia with clinical and financial outcomes following lobectomy for lung cancerCentral MessagePerspective
Konmal Ali,
Sara Sakowitz, MS, MPH,
Nikhil L. Chervu, MD, MS,
Arjun Verma, BS,
Syed Shahyan Bakhtiyar, MD, MBE,
Joanna Curry, BA,
Nam Yong Cho, BS,
Peyman Benharash, MD
Affiliations
Konmal Ali
Cardiovascular Outcomes Research Laboratories (CORELAB), University of California, Los Angeles, Calif
Sara Sakowitz, MS, MPH
Cardiovascular Outcomes Research Laboratories (CORELAB), University of California, Los Angeles, Calif
Nikhil L. Chervu, MD, MS
Cardiovascular Outcomes Research Laboratories (CORELAB), University of California, Los Angeles, Calif; Department of Surgery, University of California, Los Angeles, Calif
Arjun Verma, BS
Cardiovascular Outcomes Research Laboratories (CORELAB), University of California, Los Angeles, Calif
Syed Shahyan Bakhtiyar, MD, MBE
Cardiovascular Outcomes Research Laboratories (CORELAB), University of California, Los Angeles, Calif; Department of Surgery, University of Colorado, Aurora, Colo
Joanna Curry, BA
Cardiovascular Outcomes Research Laboratories (CORELAB), University of California, Los Angeles, Calif
Nam Yong Cho, BS
Cardiovascular Outcomes Research Laboratories (CORELAB), University of California, Los Angeles, Calif
Peyman Benharash, MD
Cardiovascular Outcomes Research Laboratories (CORELAB), University of California, Los Angeles, Calif; Department of Surgery, University of California, Los Angeles, Calif; Address for reprints: Peyman Benharash, MD, Division of Cardiac Surgery, UCLA, 64-249 Center for Health Sciences, Los Angeles, CA 90095.
Objective: The number of adults with dementia is rising worldwide. Although dementia has been linked with inferior outcomes following various operations, this phenomenon has not been fully elucidated among patients undergoing elective lung resection. Using a national cohort, we evaluated the association of dementia with clinical and financial outcomes following lobectomy for cancer. Methods: Adults undergoing lobectomy for lung cancer were identified within the 2010-2020 Nationwide Readmissions Database. Patients with a comorbid diagnosis of dementia were considered the Dementia cohort (others: Non-Dementia). Multivariable regressions were developed to evaluate the association between dementia and key outcomes. Results: Of ∼314,436 patients, 2863 (0.9%) comprised the Dementia cohort. Compared with Non-Dementia, the Dementia cohort was older (75 vs 68 years, P < .001), less commonly female (49.4 vs 53.9%, P = .01), and had a greater burden of comorbid conditions. After adjustment, dementia remained associated with similar odds of in-hospital mortality (adjusted odds ratio [aOR], 0.86; 95% confidence interval [CI], 0.54-1.38) but greater likelihood of pneumonia (aOR, 1.31; CI, 1.04-1.65) and infectious complications (aOR, 1.37; CI, 1.01-1.87). Further, dementia was associated with longer length of stay (β +0.96 days; CI, 0.51-1.41), but no difference in hospitalization cost (β $1528; CI, −92 to 3148). Conclusions: Patients with dementia faced similar odds of mortality, but greater complications and resource use following lobectomy for lung cancer. Novel interventions are needed to improve care coordination and develop standardized recovery pathways for this growing cohort.
