Exercise ventilatory inefficiency, age and peak oxygen consumption as postoperative mortality and complications predictors in surgery for lung cancer

2014 
AIM of this study was to investigate in a large sample of patients the role of respiratory functional parameters at rest and during exercise as predictors of postoperative death or complications after lung surgery for cancer. PATIENTS AND METHODS: a retrospective analysis was performed on 264 consecutive patients with lung cancer (213 males, 51 females), mean aged 65+8years, operable according to current standards (ERS/ESTS) in which lung resection was performed after complete preoperative study with cardiopulmonary exercise test. RESULTS: Thirty-nine (14.8%) had serious complications, 12 (4.5%) died within 30 days from surgery. 187 patients had lobectomy or bilobectomy with 27/187 (14.4%) serious complications and 7/187 (3.7%) postoperative deaths; 77 had pneumonectomy with 12/77 (15.6%) serious complications and 5/77 (6.5%) deaths. Considering all preoperative and predicted post operative parameters a logistic regression analysis individuated age [Odds ratio(OR): 1.19 z= 2.89 p<0.004], V'E/V'C02 slope [Odds ratio(OR): 1.14 z= 2.85 p<0.005] and V'02peak (%predicted) (OR: 0.92 z= 2.68 p<0.007) as independent mortality predictors. Best predictors for the occurrence of severe cardiopulmonary post-operative complications were instead V'02peak (mL/Kg/min) (OR: 0.96 z= 2.25 p<0.025) and V'E/V'C02 slope [Odds ratio(OR): 1.06 z= 2.00 p<0.04). CONCLUSIONS: High V'E/V'C02 slope and low V'02peak are predictors of death and complications after lung surgery. Advanced age is an additional risk factor for death.
    • Correction
    • Source
    • Cite
    • Save
    • Machine Reading By IdeaReader
    0
    References
    0
    Citations
    NaN
    KQI
    []