| A clinical prediction rule for pulmonary complications after thoracic surgery for primary lung cancer. | |
| | |
MedLine Citation:
|
PMID: 19861366 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: There is controversy surrounding the value of the predicted postoperative diffusing capacity of lung for carbon monoxide (DLCOppo) in comparison to the forced expired volume in 1 s for prediction of pulmonary complications (PCs) after thoracic surgery. METHODS: Using a prospective database, we performed an analysis of 956 patients who had resection for lung cancer at a single institution. PC was defined as the occurrence of any of the following: atelectasis, pneumonia, pulmonary embolism, respiratory failure, and need for supplemental oxygen at hospital discharge. RESULTS: PCs occurred in 121 of 956 patients (12.7%). Preoperative chemotherapy (odds ratio 1.64, 95% confidence interval 1.06-2.55, P = 0.02, point score 2) and a lower DLCOppo (odds ratio per each 5% decrement 1.13, 95% confidence interval 1.06-1.19, P < 0.0001, point score 1 per each 5% decrement of DLCOppo less than 100%) were independent risk factors for PCs. We defined 3 overall risk categories for PCs: low < or =10 points, 39 of 448 patients (9%); intermediate 11-13 points, 37 of 256 patients (14%); and high > or =14 points, 42 of 159 patients (26%). The median (range) length of hospital stay was significantly greater for patients who developed PCs than for those who did not: 12 (3-113) days vs 6 (2-39) days, P < 0.0001, respectively. Similarly, 30-day mortality was significantly more frequent for patients who developed PCs than for those who did not: 16 of 121 (13.2%) vs 6 of 835 (0.7%), P < 0.0001. CONCLUSIONS: These data show that PCs after thoracic surgery for lung cancer can be predicted with moderate accuracy based on DLCOppo and whether patients had chemotherapy. Forced expired volume in 1 s was not a predictor of PCs. |
| | |
Authors:
|
David Amar; Daisy Munoz; Weiji Shi; Hao Zhang; Howard T Thaler |
Related Documents
:
|
15739526 - Chronological changes of postsympathectomy compensatory hyperhidrosis and recurrent swe... 19561896 - Comparison of clinicoradiologic manifestation of nonspecific interstitial pneumonia and... 18154816 - Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer co... 17016386 - Optimizing preoperative lung function. 22144536 - A retrospective comparison of ceftriaxone versus oxacillin for osteoarticular infection... 21628696 - A prospective outcome study of neonatal cerebral sinovenous thrombosis. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-10-27 |
Journal Detail:
|
Title: Anesthesia and analgesia Volume: 110 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2010 May |
Date Detail:
|
Created Date: 2010-04-26 Completed Date: 2010-05-13 Revised Date: 2010-05-28 |
Medline Journal Info:
|
Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
|
Languages: eng Pagination: 1343-8 Citation Subset: AIM; IM |
Affiliation:
|
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. amard@mskcc.org |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Anaerobic Threshold Analysis of Variance Antineoplastic Combined Chemotherapy Protocols / therapeutic use Carbon Monoxide / diagnostic use Female Forced Expiratory Volume Health Care Costs Humans Length of Stay Lung Diseases / economics, epidemiology, etiology* Lung Neoplasms / complications, economics, surgery* Male Middle Aged Postoperative Complications / economics, epidemiology, etiology* Predictive Value of Tests Prognosis Pulmonary Diffusing Capacity Regression Analysis Risk Assessment Spirometry Thoracic Surgical Procedures* Walking / physiology |
| Chemical | |
Reg. No./Substance:
|
630-08-0/Carbon Monoxide |
| Comments/Corrections | |
Comment In:
|
Anesth Analg. 2010 May 1;110(5):1261-3
[PMID:
20418289
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Closed-Circuit Xenon Delivery Using a Standard Anesthesia Workstation.
Next Document: Heparin concentration-based anticoagulation for cardiac surgery fails to reliably predict heparin bo...