Preoperative peak expiratory flow (PEF) for predicting postoperative pulmonary complications after lung cancer lobectomy: a prospective study with 725 cases

Background: The study aimed to investigate the correlation between peak expiratory flow (PEF) and postoperative pulmonary complications (PPCs) for lung cancer patients undergoing lobectomy. Methods: Patients who were diagnosed with resected non-small cell lung cancer (NSCLC) (n=725) were prospectively analyzed and the relationship between the preoperative PEF and PPCs was evaluated based on patients’ basic characteristics and clinical data in hospital Results: Among the 725 included patients, 144 of them were presented PPCs in 30 days after lobectomy, which were divided into PPCs group. PEF value (294.2±85.1 vs. 344.7±89.6 L/min; P 300 L/min (45.0%, 100/222 vs. 8.7%, 44/503, P 48 h (5.4%, 12/222 vs. 2.4%, 12/503, P=0.036) were higher in the group with PEF value ≤300 L/min. Conclusions: The presented study revealed a significant correlation between a low PEF value and PPCs in surgical lung cancer patients receiving lobectomy, indicating the potential of a low PEF as an independent risk factor for the occurrence of PPCs and a PPC-guided (PEF value ≤300 L/min) risk assessment could be meaningful for the perioperative management of lung cancer candidates waiting for surgery.