title: Risk factors for pulmonary complications in patients with sarcoma after the resection of pulmonary nodules by thoracotomy.
abstract: OBJECTIVE
  To identify the risk factors for pulmonary complications after thoracotomy for the resection of pulmonary nodules in patients with sarcoma.
  
  
  METHODS
  A retrospective cohort study involving 68 consecutive patients diagnosed with sarcoma and submitted to a total of 174 thoracotomies for the resection of pulmonary nodules. The dependent variable was defined as the occurrence of any postoperative pulmonary complications. The independent variables were related to the patient, underlying diagnosis, and type of surgical procedure. We analyzed the data using a multivariate generalized estimating equations model with logistic link function and a symmetric correlation structure.
  
  
  RESULTS
  Complications were observed in 24 patients (13.8%, 95% CI: 9.0-19.8), and there was one death. The mean length of hospital stay was twice as long in the patients with postoperative complications as in those without (18.8 ± 10.0 days vs. 8.6 ± 6.0 days; p < 0.05). The variables that correlated with the outcome measure were the type of resection (wedge vs. anatomic; OR = 3.6; 95% CI: 1.5-8.8), the need for blood transfusion (OR = 9.8; 95% CI: 1.6-60.1), and the number of nodules resected (OR = 1.1; 95% CI: 1.0-1.1). The multivariate model showed an area under the ROC curve of 0.75 (95% CI: 0.65-0.85).
  
  
  CONCLUSIONS
  Postoperative pulmonary complications were common after pulmonary nodule resection in patients with sarcoma, occurring in approximately 10% of the procedures. The occurrence of such complications can be expected when techniques other than wedge resection are employed, when blood transfusion is required, and when a great number of nodules are resected. Therefore, it is possible to identify patients at risk for pulmonary complications, who should be closely monitored in the immediate postoperative period. In such patients, all preventive measures should be taken.
authors.affiliation: SARAH-Brasília, Rede SARAH de Hospitais de Reabilitação, Brasília, DF, Brasil.
authors.forename: Rogério
authors.initials: R
authors.lastname: Santos Silva
authors.forename: Paulo Sérgio Siebra
authors.initials: PS
authors.lastname: Beraldo
authors.forename: Flávia Ferretti
authors.initials: FF
authors.lastname: Santiago
authors.forename: Daniel Sammartino
authors.initials: DS
authors.lastname: Brandão
authors.forename: Eduardo Magalhães
authors.initials: EM
authors.lastname: Mamare
authors.forename: Thomas Anthony
authors.initials: TA
authors.lastname: Horan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology*; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012509:Sarcoma / Q000601:surgery*; D003074:Solitary Pulmonary Nodule / Q000473:pathology / Q000601:surgery*; D013908:Thoracotomy / Q000009:adverse effects* / Q000379:methods; D065227:Transfusion Reaction; D055815:Young Adult