Gender, race, and socioeconomic status affects outcomes after lung cancer resections in the United States

Abstract

Background: The effect of gender, race, and socioeconomic status on contemporary outcomes after lung cancer resections has not been comprehensively evaluated across the United States. We hypothesized that risk-adjusted outcomes for lung cancer resections would not be influenced by these factors.

Methods: From 2003 to 2007, 129,207 patients undergoing lung cancer resections were evaluated using the Nationwide Inpatient Sample (NIS) database. Multiple regression analysis was used to estimate the effects of gender, race, and socioeconomic status on risk-adjusted outcomes.

Results: Average patient age was 66.8±10.5 years. Women accounted for 5.0% of the total study population. Among racial groups, whites underwent the largest majority of operations (86.2%), followed by black (6.9%) and Hispanic (2.8%) races. Overall the incidence of mortality was 2.9%, postoperative complications were 30.4%, and pulmonary complications were 22.0%. Female gender, race, and mean income were all multivariate correlates of adjusted mortality and morbidity. Black patients incurred decreased risk-adjusted morbidity and mortality compared with white patients. Hispanics and Asians demonstrated decreased risk-adjusted complication rates. Importantly low income status independently increased the adjusted odds of mortality.

Conclusions: Female gender is associated with decreased mortality and morbidity after lung cancer resections. Complication rates are lower for black, Hispanic, and Asian patients. Low socioeconomic status increases the risk of in-hospital death. These factors should be considered during patient risk stratification for lung cancer resection.