Mortality risk factors in lobectomies: Single-institution study
, , , , , e | 09 dic 2019
INFORMAZIONI SU QUESTO ARTICOLO
Pubblicato online: 09 dic 2019
Pagine: 130 - 137
DOI: https://doi.org/10.2478/pneum-2019-0025
Parole chiave
© 2019 Bogdan I. Popovici et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Characteristics of postoperative pleural drainage in the study group
| Drainage Day 1 (mL) | 497.92 ± 226.91 | 492.51 ± 221.00 | 700 ± 367.42 | |
| Drainage Day 1 >650 mL (cut-off) | 37 (19.3%) | 34 (18.2%) | 3 (60.0%) | |
| Drainage Day 2 (mL) | 273.70 ± 139.70 | 268.72 ± 128.67 | 460.00 ± 343.51 | |
| Drainage Day 2 >550 mL (cut-off) | 9 (4.7%) | 7 (3.7%) | 2 (40%) | |
| Drainage Day 1 + Day 2 >950 mL (cut-off) | 37 (19.3%) | 34 (18.2%) | 3 (60.0%) | |
| Haemorrhage Day 1 >1,000 mL | 12 (6.3%) | 11 (5.9%) | 1 (20.0%) | 0.278 |
| Haemorrhage Day 1 + Day 2 >1,500 mL | 13 (6.8%) | 11 (5.9%) | 2 (40.0%) | |
The impact of RFs on mortality in lobectomies as found in multivariate analysis
| Thrombocytosis | 7.41 | 0.142 | 0.51 | 107.77 |
| COPD | 2.45 | 0.543 | 0.14 | 44.16 |
| Digestive conditions | 4.89 | 0.2566 | 0.32 | 75.69 |
| Neoadjuvant chemotherapy | 2.03 | 0.615 | 0.13 | 31.69 |
| TB | 11.39 | 0.098 | 0.64 | 203.35 |
| Drainage Day 2 >550 mL | 2.63 | 0.580 | 0.15 | 221.42 |
| Haemorrhage >1,500 mL | 5.84 | 0.314 | 0.15 | 221.42 |
Pathological characteristics of patients having undergone lobectomy
| Associated infections | Nonspecific | 40 (20.8%) | 39 (20.9%) | 1 (20.0%) | |
| TB | 13 (6.8%) | 11 (5.9%) | 2 (40.0%) | ||
| No infection | 139 (72.4%) | 137 (73.3%) | 2 (40%) | ||
| TB | Without TB | 179 (93.2%) | 176 (94.1%) | 3 (60%) | |
| With TB | 13 (6.8%) | 11 (5.9%) | 2 (40.0%) | ||
| Pathological diagnosis | Abscess | 10 (5.2%) | 10 (5.3%) | 0 (0.0%) | 0.155 |
| Benign | 3 (1.6%) | 3 (1.6%) | 0 (0.0%) | ||
| Bronchiectasis | 3 (1.6%) | 3 (1.6%) | 0 (0.0%) | ||
| Adenocarcinoma | 68 (35.4%) | 65 (34.8%) | 3 (60.0%) | ||
| Carcinoma | 43 (22.4%) | 43 (23.0%) | 0 (0.0%) | ||
| Other NSCLC | 27 (14.1%) | 27 (14.4%) | 0 (0.0%) | ||
| Sarcoma | 9 (4.7%) | 9 (4.8%) | 0 (0.0%) | ||
| Carcinoid | 8 (4.2%) | 8 (4.7%) | 0 (0.0%) | ||
| TB | 11 (4.2%) | 9 (4.8% | 2 (18.8%) | ||
| Other rare findings | 9 (4.7%) | 9 (4.8%) | 0 (0.0%) | ||
| Malignant conditions | 157 (81.8%) | 154 (82.4%) | 3 (60%) | 0.225 | |
| Benign conditions | 35 (18.2%) | 33 (17.6%) | 2 (40.0%) | 0.225 | |
| TNM 7 stages | IA | 11 (5.7%) | 9 (4.8%) | 2 (40.0%) | 0.054 |
| IB | 31 (16.1%) | 31 (16.6%) | 0 (0.0%) | ||
| IIA | 36 (18.8%) | 36 (19.3%) | 0 (0.0%) | ||
| IIB | 35 (18.2%) | 34 (18.2%) | 1 (20.0%) | ||
| IIIA | 26 (13.5%) | 26 (13.9%) | 0 (0.0%) | ||
| IIIB | 7 (3.6%) | 7 (3.7%) | 0 (0.0%) | ||
| IV | 4 (2.1%) | 4 (2.1%) | 0 (0.0%) | ||
Functional and laboratory characteristics of patients
| Age (years) | 57.48 ± 11.11 | 57.35 ± 10.99 | 62.40 ± 15.58 | 0.317 |
| Male sex | 139 (72.4%) | 134 (71.7%) | 5 (100%) | 0.325 |
| Smoking [>20 packs per year (P/Y)] | 156 (81.3%) | 152 (81.3%) | 4 (80.0%) | 1.000 |
| Total lung capacity% (TLC%) | 77.73 ± 14.12 | 84.42 ± 14.85 | 77.55 ± 14.10 | 0.284 |
| FEV1% | 84.34 ± 16.68 | 80.04 ± 15.26 | 84.45 ± 16.75 | 0.561 |
| FEV25–75% | 74.43 ± 28.45 | 60.20 ± 29.22 | 74.82 ± 28.41 | 0.258 |
| Oxygen saturation (arterial blood) (SaO2) | 95.55 ± 2.89 | 96.64 ± 1.13 | 95.52 ± 2.92 | 0.393 |
| Partial pressure of oxygen in arterial blood (PaO2) | 81.35 ± 17.93 | 84.40 ± 8.40 | 81.27 ± 18.12 | 0.701 |
| Partial pressure of carbon dioxide in arterial blood (PaCO2) | 39.04 ± 5.22 | 40.52 ± 2.60 | 39.00 ± 5.27 | 0.522 |
| pH | 7.38 ± 0.05 | 7.37 ± 0.03 | 7.38 ± 0.05 | 0.581 |
| Pulmonary artery pressures (PAPs) | 28.74 ± 6.12 | 32.40 ± 2.51 | 28.65 ± 6.16 | 0.176 |
| Left ventricle ejection fraction% (LVEF%) | 55.09 ± 5.67 | 54.60 ± 4.45 | 55.10 ± 5.71 | 0.846 |
| Leucocytosis | 77 (40.1%) | 73 (39.0%) | 4 (80.0%) | 0.159 |
| Anaemia | 103 (53.6%) | 99 (52.9%) | 4 (80.0%) | 0.375 |
| Thrombocytosis | 20 (10.4%) | 17 (9.1%) | 3 (60.0%) | |
| Inflammatory markers | 117 (60.9%) | 114 (61.0%) | 3 (60.0%) | 1.000 |
Characteristics of the anaesthesia and surgery
| Previous thoracotomy | 7 (3.6%) | 7 (3.7%) | 0 (0.0%) | 1.000 | |
| Emergency lobectomy | 6 (3.1%) | 5 (2.7%) | 1 (20%) | 0.148 | |
| ASA | I | 8 (4.2%) | 8 (4.3%) | 0 (0.0%) | < |
| II | 79 (41.1%) | 78 (41.7%) | 1 (20.0%) | ||
| III | 104 (54.2%) | 101 (54.0%) | 3 (60.0%) | ||
| IV | 1 (0.5%) | 0 (0.0%) | 1 (20.0%) | ||
| Lobectomy | Right upper lobe (RUL) | 49 (25.5%) | 47 (25.1%) | 2 (40.0%) | 0.188 |
| Medium lobe (ML) | 12 (6.3%) | 12 (6.4%) | 0 (0.0%) | ||
| Right lower lobe (RLL) | 44 (22.9%) | 41 (21.9%) | 3 (60.0%) | ||
| Left upper lobe (LUL) | 47 (24.5%) | 47 (25.1%) | 0 (0.0%) | ||
| Left lower lobe (LLL) | 40 (20.8%) | 40 (21.4%) | 0 (0.0%) | ||
| Duration of intervention | 3.19 ± 1.02 | 3.20 ± 1.03 | 3.02 ± 1.04 | 0.704 | |
Comorbidities of lobectomy patients
| Cardiovascular conditions | 98 (51.0%) | 95 (50.8%) | 3 (60.0%) | 1.000 |
| Diastolic dysfunction | 46 (24.0%) | 44 (23.5%) | 2 (40.0%) | 0.595 |
| Respiratory disease | 79 (41.1%) | 75 (40.1%) | 4 (80.0%) | 0.161 |
| COPD | 65 (33.9%) | 61 (32.6%) | 4 (80.0%) | |
| Neuro-psychiatric conditions | 16 (8.3%) | 16 (8.6%) | 0 (0.0%) | 1.000 |
| Metabolic diseases | 41 (21.4%) | 41 (21.9%) | 0 (0.0%) | 0.586 |
| Diabetes mellitus | 15 (7.8%) | 15 (8.0%) | 0 (0.0%) | 1.000 |
| Urogenital conditions | 14 (7.3%) | 13 (7.0%) | 1 (20%) | 0.318 |
| Kidney failure | 9 (4.7%) | 9 (4.8%) | 0 (0.0%) | 1.000 |
| Digestive conditions | 36 (18.8%) | 33 (17.6%) | 3 (60.0%) | |
| Osteoarticular conditions | 15 (7.8%) | 15 (8.0%) | 0 (0.0%) | 1.000 |
| Skin diseases | 6 (3.1%) | 6 (3.2%) | 0 (0.0%) | 1.000 |
| Associated cancers | 19 (9.9%) | 18 (9.6%) | 1 (20.0%) | 0.410 |
| Number of comorbidities | 1.81 ± 1.717 | 1.80 ± 1.723 | 2.40 ± 1.517 | 0.440 |
| Neoadjuvant chemotherapy | 55 (28.6%) | 51 (27.3%) | 4 (80%) | |
| Preoperative radiotherapy | 5 (2.6%) | 5 (2.7%) | 0 (0.0%) | 1.000 |