Lactate dehydrodgenase levels predict pulmonary morbidity after lung resection for non-small cell lung cancer.
OBJECTIVE
The prevention of pulmonary complication after pulmonary resection for non-small cell lung cancer may minimize postoperative mortality rates and hospitalization period. The purpose of this study was to identify preoperative factors associated with the development of pulmonary complications after lung resections to help predict which patients are at increased risk for morbidity.


METHODS
From January 2000 to June 2003, 108 consecutive pulmonary resections were performed for non-small cell lung cancer in our institution. The following information was recorded: demographic, clinical, functional, and surgical variables. We evaluated all complications, which arose after pulmonary resection during hospitalization. The risk of complication was evaluated using univariate and multiple logistic regression analysis to estimate odds ratio.


RESULTS
Sixty-six lobectomies, 31 pneumonectomies, 11 bilobectomies and four wedge resections were done. Forty-nine complications were realized in all patients. A logistic regression analysis on relevant variables showed that only the increased serum lactate dehydrogenase (LDH) levels (>320 U/l) was a significant predictor of a pulmonary complication (P=0.03). Age, side of resection, low FEV(1), stage of the disease, low partial arterial oxygen pressure, low partial arterial carbon dioxide pressure, cigarette smoking and concomitant disease were not significant predictors of morbidity.


CONCLUSIONS
Patients who have higher serum LDH levels are at increased risk for developing postoperative morbidity. Postoperative physical therapy and medical care might be intensified in those patients at high risk.
Turna
Akif
A
Department of Thoracic Surgery, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey. aturna@turk.net
Solak
Okan
O
Cetinkaya
Erdoğan
E
Kiliçgün
Ali
A
Metin
Muzaffer
M
Sayar
Adnan
A
Gürses
Atilla
A
D000230:Adenocarcinoma / Q000201:enzymology / Q000601:surgery; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000201:enzymology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000201:enzymology / Q000601:surgery; D004796:Clinical Enzyme Tests; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D016015:Logistic Models; D008175:Lung Neoplasms / Q000201:enzymology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012307:Risk Factors
D015415:Biomarkers; D007770:L-Lactate Dehydrogenase