Usefulness of combining clinical and biochemical parameters for prediction of postoperative pulmonary complications after lung resection surgery

Background: We aimed to investigate the impact of intraoperative blood loss on postoperative pulmonary complications in patients who underwent video-assisted thoracoscopic lobectomy for nonsmall cell lung cancer. Methods: Data of a total of 409 patients (227 males, 182 females; median age: 62 years; range, 20 to 86 years) who underwent lung resection for Stage I-IIIa non-small cell lung cancer in our clinic between July 2017 and April 2018 were retrospectively analyzed. The receiver operating characteristic analysis was used to confirm the threshold value of intraoperative blood loss for the prediction of postoperative pulmonary complications. Propensity score matching was performed to compare between high-intraoperative blood loss and low-intraoperative blood loss groups. A post-matching conditional logistic regression was conducted to determine the independent risk factors for postoperative pulmonary complications. Results: Of the patients, 86 (21.03%) developed postoperative pulmonary complications. In the propensity score matching analysis, intraoperative blood loss was shown to be a predictive factor of postoperative pulmonary complications (3.992; 95% confidence interval [CI]: 1.54-10.35; p=0.004). The rate of postoperative pulmonary complications in high-intraoperative blood loss group was significantly higher than that the low-intraoperative blood loss group (37.5% vs. 13.9%, respectively; p=0.003). The postoperative length of stay and duration of postoperative antibiotic use were significantly prolonged in the high-intraoperative blood loss group. Conclusion: Intraoperative blood loss serves as a significant risk factor for postoperative pulmonary complications after lung resection for non-small cell lung cancer. Surgeons should strive to reduce intraoperative blood loss for better surgical outcomes.

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Short-Physical Performance Battery (SPPB) score is associated with postoperative pulmonary complications in elderly patients undergoing lung resection surgery: A prospective multicenter cohort study

Chronic Respiratory Disease ◽

10.1177/1479973120961846 ◽

2020 ◽

Vol 17 ◽

pp. 147997312096184

Author(s):

Masatoshi Hanada ◽

Kota Yamauchi ◽

Shinjiro Miyazaki ◽

Yohei Oyama ◽

Yorihide Yanagita ◽

...

Keyword(s):

Cohort Study ◽

Elderly Patients ◽

Physical Performance ◽

Lung Resection ◽

Pulmonary Complications ◽

Short Physical Performance Battery ◽

Postoperative Pulmonary Complications ◽

Multicenter Cohort Study ◽

Multicenter Cohort ◽

The Impact

Elderly patients awaiting lung resection surgery often have poor physical function, which puts them at a high risk of postoperative pulmonary complications. The aim of this study was to investigate the impact of preoperative physical performance on postoperative pulmonary complications in patients awaiting lung resection surgery. In this prospective multicenter cohort study, the characteristics of patients and postoperative pulmonary complications were compared between subjects with low (<10) and high (≥10) Short Physical Performance Battery (SPPB) scores. Postoperative pulmonary complications were defined as over grade II in Clavien-Dindo classification system. We estimated the effects of physical performance on postoperative pulmonary complications using multivariable hierarchical logistic regression. The postoperative pulmonary complications were compared between 331 patients in the high and 33 patients in the low SPPB group. Patients in the low SPPB score group had a significantly higher rate of postoperative pulmonary complications (p < 0.001). Low SPPB score was associated with a higher risk of postoperative pulmonary complications (odds ratio, 8.80; p < 0.001). The SPPB is a clinically useful evaluation tool to assess surgical patients’ physical performance. The low physical performance indicated by the SPPB may be predictive of postoperative pulmonary complications after lung resection surgery. Trial registration: Clinical Trials. University hospital Medical Information Network Center (UMIN-CTR) UMIN000021875.

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DEVELOPMENT AND IMPACT OF EXERCISE PROGRAM ON POSTOPERATIVE PULMONARY COMPLICATIONS FOLLOWING LUNG RESECTION

CHEST Journal ◽

10.1378/chest.134.4_meetingabstracts.s12002 ◽

2008 ◽

Vol 134 (4) ◽

pp. 12S

Author(s):

Abdelbaset M. Saleh ◽

Magda A. Ahmad ◽

Karima El-shamy ◽

Shahir K. Georg ◽

Mohamed Fouda

Keyword(s):

Lung Resection ◽

Exercise Program ◽

Pulmonary Complications ◽

Postoperative Pulmonary Complications

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Influence of enhanced recovery after surgery (ERAS) on patients receiving lung resection: a retrospective study of 1749 cases

BMC Surgery ◽

10.1186/s12893-020-00960-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chunmei Wang ◽

Yutian Lai ◽

Pengfei Li ◽

Jianhuan Su ◽

Guowei Che

Keyword(s):

Lung Cancer ◽

Logistic Regression ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Lung Resection ◽

Hospital Costs ◽

Lung Cancer Surgery ◽

Pulmonary Complications ◽

Hospital Length Of Stay ◽

Postoperative Pulmonary Complications

Abstract Background The study aimed to evaluate the outcomes following the implementation of enhanced recovery after surgery (ERAS) for patients undergoing lung cancer surgery. Method A retrospective cohort study involving 1749 patients with lung cancer undergoing pulmonary resection was conducted. The patients were divided into two time period groups for analysis (routine pathway and ERAS pathway). Logistic regression analysis was performed to assess the risks of developing postoperative pulmonary complications. Results Among the 1749 patients, 691 were stratified into the ERAS group, and 1058 in to the routine group. The ERAS group presented with shorter postoperative in-hospital length of stay (LOS) (4.0 vs 6.0, P < 0.001), total LOS (10.0 vs. 13.0 days, P < 0.001), and lower total in-hospital costs (P < 0.001), including material (P < 0.001) and drug expenses (P < 0.001). Furthermore, the ERAS group also presented with a lower occurrence of postoperative pulmonary complications (PPCs) than the routine group (15.2% vs. 19.5%, P = 0.022). Likewise, a significantly lower occurrence of pneumonia (8.4% vs. 14.2%, P < 0.001) and atelectasis (5.9% vs. 9.8%, P = 0.004) was found in the ERAS group. Regarding the binary logistic regression, the ERAS intervention was the sole independent factor for the occurrence of PPCs (OR: 0.601, 95% CI 0.434–0.824, P = 0.002). In addition, age (OR: 1.032, 95% CI 1.018–1.046), COPD (OR: 1.792, 95% CI 1.196–2.686), and FEV1 (OR: 0.205, 95% CI 0.125–0.339) were also independent predictors of PPCs. Conclusion Implementation of an ERAS pathway shows improved postoperative outcomes, including shortened LOS, lower in-hospital costs, and reduced occurrence of PPCs, providing benefits to the postoperative recovery of patients with lung cancer undergoing surgical treatment.

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Can the Melbourne Scoring Scale be used to assess postoperative pulmonary complications in high-risk patients following lung resection?

10.1183/13993003.congress-2018.pa1423 ◽

2018 ◽

Author(s):

Barbara Cristina Brocki ◽

Elisabeth Westerdahl ◽

Jane Andreasen ◽

Jan Jesper Andreasen

Keyword(s):

High Risk ◽

Lung Resection ◽

Pulmonary Complications ◽

Postoperative Pulmonary Complications ◽

High Risk Patients ◽

Risk Patients

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SMOKING AND POSTOPERATIVE PULMONARY COMPLICATIONS AFTER LUNG RESECTION: DID SOMETHING CHANGE OVER TIME?

CHEST Journal ◽

10.1016/j.chest.2021.07.2123 ◽

2021 ◽

Vol 160 (4) ◽

pp. A2457

Author(s):

Stefano Rudella ◽

Jacopo Moro ◽

Federica Mellone ◽

Roberta RAPANA' ◽

simona sobrero ◽

...

Keyword(s):

Lung Resection ◽

Pulmonary Complications ◽

Postoperative Pulmonary Complications ◽

Change Over Time ◽

Over Time

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Influence of enhanced recovery after surgery (ERAS) on patients receiving lung resection: a retrospective study of 1,749 cases

10.21203/rs.3.rs-39229/v2 ◽

2020 ◽

Author(s):

Chunmei Wang ◽

Yutian Lai ◽

Pengfei Li ◽

Jianhua Su ◽

Guowei Che

Keyword(s):

Lung Cancer ◽

Logistic Regression ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Lung Resection ◽

Hospital Costs ◽

Lung Cancer Surgery ◽

Pulmonary Complications ◽

Hospital Length Of Stay ◽

Postoperative Pulmonary Complications

Abstract Background The study aimed to evaluate the outcomes following the implementation of enhanced recovery after surgery (ERAS) for patients undergoing lung cancer surgery.Method A retrospective cohort study involving 1,749 patients with lung cancer undergoing pulmonary resection was conducted. The patients were divided into two time period groups for analysis(routine pathway and ERAS pathway). Logistic regression analysis was performed to assess the risks of developing postoperative pulmonary complications.Results Among the 1,749 patients, 691 were stratified into the ERAS group, and 1,058 in to the routine group. The ERAS group presented with shorter postoperative in-hospital length of stay (LOS) (4.0 vs 6.0, P<0.001), total LOS (10.0 VS. 13.0 days, P<0.001), and lower total in-hospital costs (P<0.001), including material (P<0.001) and drug expenses (P<0.001). Furthermore, the ERAS group also presented with a lower occurrence of postoperative pulmonary complications (PPCs) than the routine group (15.2% vs. 19.5%, P=0.022). Likewise, a significantly lower occurrence of pneumonia (8.4% vs. 14.2%, P<0.001) and atelectasis (5.9% vs. 9.8%, P=0.004) was found in the ERAS group. Regarding the binary logistic regression, the ERAS intervention was the sole independent factor for the occurrence of PPCs (OR: 0.601, 95% CI: 0.434-0.824, P=0.002). In addition, age (OR: 1.032, 95% CI: 1.018-1.046), COPD (OR: 1.792, 95% CI: 1.196-2.686), and FEV1(OR: 0.205, 95% CI: 0.125-0.339) were also independent predictors of PPCs. Conclusion Implementation of an ERAS pathway shows improved postoperative outcomes, including shortened LOS, lower in-hospital costs, and reduced occurrence of PPCs, providing benefits to the postoperative recovery of patients with lung cancer undergoing surgical treatment.

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