title: Prediction of pulmonary complications after a lobectomy in patients with non-small cell lung cancer.
abstract: BACKGROUND
  Although the preoperative prediction of pulmonary complications after lung major surgery has been reported in various papers, it still remains unclear.
  
  
  METHODS
  Eighty nine patients with stage I-IIIA non-small cell lung cancer (NSCLC) who underwent a complete resection at our institute from 1994-8 were evaluated for the feasibility of making a preoperative prediction of pulmonary complications. All had either a predicted postoperative forced vital capacity (FVC) of >800 ml/m(2) or forced expiratory volume in one second (FEV(1)) of >600 ml/m(2).
  
  
  RESULTS
  Postoperative complications occurred in 37 patients (41.2%) but no patients died during the 30 day period after the operation. Pulmonary complications occurred in 20 patients (22.5%). Univariate analysis indicated that the factors significantly related to pulmonary complications were FVC <80%, serum lactate dehydrogenase (LDH) level > or =230 U/l, and arterial oxygen tension (PaO(2)) <10.6 kPa (80 mm Hg). In a multivariate analysis the three independent predictors of pulmonary complications were serum LDH > or =230 U/l (odds ratio (OR) 10.5, 95% CI 1.4 to 77.3), residual volume (RV)/total lung capacity (TLC) > or =30% (OR 6.0, 95% CI 1.1 to 33.7), and PaO(2) <10.6 kPa (OR 5.6, 95% CI 1.4 to 22.2).
  
  
  CONCLUSIONS
  The above findings indicate that three factors (serum LDH levels of > or =230 U/l, RV/TLC > or =30%, and PaO(2) <10.6 kPa) may be associated with pulmonary complications in patients undergoing a lobectomy for NSCLC, even though the patient group was relatively small for statistical analysis of such a diverse subject as pulmonary complications.
authors: Department of Surgery II, School of Medicine, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu 807-8555, Japan. hidetaka@med.uoeh-u.ac.jp
authors: H
authors: H
authors: Uramoto
authors: R
authors: R
authors: Nakanishi
authors: Y
authors: Y
authors: Fujino
authors: H
authors: H
authors: Imoto
authors: M
authors: M
authors: Takenoyama
authors: T
authors: T
authors: Yoshimatsu
authors: T
authors: T
authors: Oyama
authors: T
authors: T
authors: Osaki
authors: K
authors: K
authors: Yasumoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008175:Lung Neoplasms / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications / Q000175:diagnosis*; D011379:Prognosis; D012120:Respiration Disorders / Q000503:physiopathology; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology
chemical_list: D015415:Biomarkers; D007770:L-Lactate Dehydrogenase; D010100:Oxygen