title: Early complications after pneumonectomy: retrospective study of 168 patients.
abstract: The purpose of this study was to assess the mortality and risk factors of complications after pneumonectomy for lung cancer. Between 1996 and 2001, we reviewed and analysed the demographic, clinical, functional, and surgical variables of 168 patients to identify risk factors of postoperative complications by univariate and multivariate analyses with Medlog software system. The mean age was 60+/-10 years, overall mortality and morbidity rates were 4.17% and 41.6%, respectively. All frequencies of respiratory complications were 1.2% for acute respiratory failure, 10.1% for pneumonia, 2.4% for acute pulmonary oedema, 4.17% for bronchopleural fistula, 2.4% for thoracic empyema and 18.5% for left recurrent nerve injuries. Postoperative arrhythmias developed in 46% of our patients. The risk factors for cardiopulmonary morbidity and mortality with univariate analysis were advanced age (P<0.01), preoperative poor performance status (P<0.015), and chronic artery disease (P<0.008). Factors adversely affecting morbidity with multivariate analysis included age (P=0.0001), associated cardiovascular disease (P=0.001), and altered forced expiratory volume in 1 s (P=0.0005). Complications after pneumonectomy are associated with high mortality. Careful attention must be paid to patients with advanced age and heart disease. Chest physiotherapy is paramount to have uneventful outcomes.
authors.affiliation: Department of Thoracic Surgery and Pulmonary Transplantation, Maison du Haut Lêveque, C.H.U Bordeaux, Bordeaux, France. ialloubi@yahoo.fr
authors.forename: Ihsan
authors.initials: I
authors.lastname: Alloubi
authors.forename: Jacques
authors.initials: J
authors.lastname: Jougon
authors.forename: Frédéric
authors.initials: F
authors.lastname: Delcambre
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Baste
authors.forename: Jean François
authors.initials: JF
authors.lastname: Velly
mesh_terms: D000367:Age Factors; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D005541:Forced Expiratory Volume; D005602:France; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011013:Pneumonectomy / Q000009:adverse effects* / Q000401:mortality; D012140:Respiratory Tract Diseases / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology* / Q000401:mortality