Faculty Collaboration Database

Early and late morbidity in patients undergoing pulmonary resection with low diffusion capacity. Ann Thorac Surg 1996 Oct;62(4):968-74; discussion 974-5

Date

10/01/1996

Pubmed ID

8823074

DOI

10.1016/0003-4975(96)00476-6

Scopus ID

2-s2.0-0030271410 (requires institutional sign-in at Scopus site)   57 Citations

Abstract

BACKGROUND: We sought to determine whether low diffusion capacity of the lung to carbon monoxide (DLCO) is a predictor of high postoperative mortality and morbidity after major pulmonary resection and whether major pulmonary resection in patients with low DLCO results in substantial long-term morbidity.

METHODS: Sixty-two major pulmonary resections were performed in 61 patients with low DLCO (DLCO < or = 60% predicted for pneumonectomy or bilobectomy; < or = 50% predicted for lobectomy). Contemporaneously, 262 other patients underwent 263 major pulmonary resections (group II). Long-term morbidity was assessed in subsets of patients with low (n = 24) and high (n = 22; DLCO > 60% predicted) DLCO.

RESULTS: The hospital mortality rates were equivalent (4.8% low DLCO versus 4.9% group II), whereas respiratory complications were more frequent in patients with low DLCO (18% versus 9.5%; p = 0.05). In the subgroup analyses, patients with low DLCO had more hospitalizations for respiratory compromise and worse median dyspnea scores. Analysis of patients with substantial dyspnea revealed an association with extended pulmonary resection and postoperative radiation therapy in patients with low DLCO.

CONCLUSIONS: Patients with low DLCO underwent major pulmonary resection with a low mortality rate and an acceptable, but increased, respiratory complication rate. Long-term respiratory morbidity was increased in patients with low DLCO; however, the extent of pulmonary resection and the use of postoperative radiation therapy may have contributed to the development of dyspnea in these patients.

Author List

Bousamra M 2nd, Presberg KW, Chammas JH, Tweddell JS, Winton BL, Bielefeld MR, Haasler GB

Author

Kenneth W. Presberg MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Female
Hospital Mortality
Humans
Male
Middle Aged
Pneumonectomy
Postoperative Complications
Pulmonary Diffusing Capacity
Risk Factors
Vital Capacity