165705 20260113234335.0 doi 10.1093/ejcts/ezac122 sideral 131339 ART-2022-131339 eng Recuero-Díaz, Jose Luis Treatment and intention-to-treat propensity score analysis to evaluate the impact of video-assisted thoracic surgery on 90-day mortality after anatomical resection for lung cancer 2022 OBJECTIVES The aim of this study was to know the treatment effect of video-assisted thoracic surgery (VATS) on 90-day mortality after anatomical lung resection based on a nationwide cohort. METHODS This is a multicentre prospective cohort of 2721 anatomical resections for lung cancer from December 2016 to March 2018. Treatment and intention-to-treat (ITT) analyses were performed after inverse probability score weighting and different propensity score matching algorithms. Covariate balance was assessed by standardized mean differences. The estimators reported were the average treatment effect, the average treatment effect on the treated and odds ratios after conditional logistic models with 95% confidence intervals. The unconfoundedness assumption was evaluated by sensitivity analysis for average treatment effect (c-dependence) and average treatment effect on the treated (Γ). RESULTS VATS was the initial approach in 1911 patients (70.2%), though 273 cases (14.3%) had to be converted to thoracotomy. Ninety-day mortality rates were: treatment analysis (VATS 1.16% vs open 3.9%, P < 0.001), ITT analysis (VATS 1.78% vs open 3.36%, P = 0.012). After inverse probability score weighting and propensity score matching, in the treatment analysis, VATS meant absolute risk reductions between 2.25% and 2.96% and relative risk reductions between 65% and 70% [OR = 0.34 (95% confidence interval 0.15–0.79), all P-values <0.004). However, all the estimators turned out to be non-significant in the ITT analyses. A high sensitivity to unobservable confounders was proved (c-dependence 0.135, Γ = 1.5). CONCLUSIONS VATS can reduce the risk of 90-day mortality after anatomical lung resection. However, the implications of conversion to thoracotomy, comparing ITT versus treatment analysis, and the potential impact of hidden bias should deserve further attention in the future. Access copy available to the general public Unrestricted info:eu-repo/semantics/openAccess All rights reserved http://www.europeana.eu/rights/rr-f/ 3.4 2022 SURGERY 39 / 213 = 0.183 2022 Q1 T1 CARDIAC & CARDIOVASCULAR SYSTEMS 63 / 143 = 0.441 2022 Q2 T2 RESPIRATORY SYSTEM 33 / 66 = 0.5 2022 Q2 T2 1.183 2022 Cardiology and Cardiovascular Medicine 2022 Q1 Surgery 2022 Q1 Pulmonary and Respiratory Medicine 2022 Q1 Medicine (miscellaneous) 2022 Q1 5.7 2022 info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion Royo-Crespo, Iñigo Gómez de-Antonio, David Call, Sergi Aguinagalde, Borja Gómez-Hernández, María Teresa Hernández-Ferrández, Jorge Sánchez-Lorente, David Sesma-Romero, Julio Rivo, Eduardo Moreno-Mata, Nicolás Embun, Raul Universidad de Zaragoza (orcid)0000-0003-0249-3104 1013 090 Universidad de Zaragoza Dpto. Cirugía Área Cirugía 62, 3 (2022), ezac122 [9 pp.] Eur. j. cardio-thorac. surg. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY 1010-7940 510322 http://zaguan.unizar.es/record/165705/files/texto_completo.pdf Postprint 1687204 http://zaguan.unizar.es/record/165705/files/texto_completo.jpg?subformat=icon icon Postprint oai:zaguan.unizar.es:165705 articulos driver 2026-01-13-22:06:25 ARTICLE