title: Factors affecting major morbidity after video-assisted thoracic surgery for lung cancer.
abstract: BACKGROUND
  Video-assisted thoracic surgery (VATS) has been widely applied in the treatment of lung cancer. However, few studies have focused on the clinical factors predicting the major postoperative complications.
  
  
  METHODS
  Clinical data from 525 patients who underwent resection of primary lung cancer with VATS from January 2007-August 2011 were retrospectively analyzed. Risk factors related to major postoperative complications were assessed by univariate and multivariate analyses with logistic regression.
  
  
  RESULTS
  Major complications occurred in 36 (6.86%) patients, of which seven died (1.33%) within 30 d, postoperatively. Major complications included respiratory failure, hemothorax, myocardial infarction, heart failure, bronchial fistula, cerebral infarction, and pulmonary embolism. Univariate and multivariate logistic regression analyses demonstrated that age >70 y (odds ratio [OR], 2.105; 95% confidence interval [CI] 1.205-3.865), forced expiratory volume during the first second expressed as a percentage of predicted ≤70% (OR, 2.106; 95% CI 1.147-3.982) combined with coronary heart disease (OR, 2.257; 95% CI 1.209-4.123) were independent prognostic factors for major complications.
  
  
  CONCLUSIONS
  Age >70 and forced expiratory volume during the first second expressed as a percentage of predicted ≤70% combined with coronary heart disease are independent prognostic factors for postoperative major complications. Patients in these groups should undergo careful preoperative evaluation and perioperative management.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Affiliated Hospital of Jiangnan University, The Fourth People's Hospital of Wuxi City, Wuxi, People's Republic of China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Affiliated Hospital of Jiangnan University, The Fourth People's Hospital of Wuxi City, Wuxi, People's Republic of China.
authors.forename: Jiru
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Emergency Surgery, Affiliated Hospital of Jiangnan University, The Fourth People's Hospital of Wuxi City, Wuxi, People's Republic of China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Cheng
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Affiliated Hospital of Jiangnan University, The Fourth People's Hospital of Wuxi City, Wuxi, People's Republic of China.
authors.forename: Xianhua
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Affiliated Hospital of Jiangnan University, The Fourth People's Hospital of Wuxi City, Wuxi, People's Republic of China.
authors.forename: Zhenjun
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Affiliated Hospital of Jiangnan University, The Fourth People's Hospital of Wuxi City, Wuxi, People's Republic of China.
authors.forename: Chuanxin
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Affiliated Hospital of Jiangnan University, The Fourth People's Hospital of Wuxi City, Wuxi, People's Republic of China. Electronic address: wxsyxzt@163.com.
authors.forename: Zongtao
authors.initials: Z
authors.lastname: Xie
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001983:Bronchial Fistula / Q000209:etiology / Q000401:mortality; D002544:Cerebral Infarction / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D006491:Hemothorax / Q000209:etiology / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008175:Lung Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D011013:Pneumonectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality*; D011655:Pulmonary Embolism / Q000209:etiology / Q000401:mortality; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013906:Thoracoscopy / Q000009:adverse effects* / Q000706:statistics & numerical data
keywords: Complications; Lung cancer; Risk factors; Surgery; Thoracoscopy