Predictors of early morbidity after major lung resection in patients with and without airflow limitation.
BACKGROUND
The aim of the present study was to identify predictors of morbidity after major lung resection for non-small cell lung carcinoma in patients with forced expiratory volume in 1 second (FEV1) greater than or equal to 70% of predicted and in those with FEV1 less than 70% of predicted.


METHODS
Five hundred forty-four patients who underwent lobectomy or pneumonectomy from 1993 through 2000 were retrospectively analyzed. The patients were divided into two groups: group A (450 cases), with FEV1 greater than or equal to 70%, and group B (94 cases), with FEV1 less than 70%. Differences between complicated and uncomplicated patients were tested within each group.


RESULTS
Morbidity rate was not significantly different between group A and group B (20.4% and 24.5%, respectively; p = 0.4). In group A, multivariate analysis showed that predicted postoperative FEV1 was the only significant independent predictor of complications. In group B, no significant predictor was identified.


CONCLUSIONS
In patients with preoperative FEV1 less than 70% of predicted, predicted postoperative FEV1 was not predictive of postoperative morbidity. Thus, predicted postoperative FEV1 should not be used alone as a selection criteria for operation in these high-risk patients.
Brunelli
Alessandro
A
Department of Thoracic Surgery, University of Ancona, Italy. alexit_2000@yahoo.com
Al Refai
Majed
M
Monteverde
Marco
M
Sabbatini
Armando
A
Xiumé
Francesco
F
Fianchini
Aroldo
A
D002289:Carcinoma, Non-Small-Cell Lung / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy