Printer Friendly

Risk factors identified for prolonged stay after lobectomy.

Renal dysfunction and insulin dependency are the highest risk factors for prolonged length of stay following lobectomy for lung cancer, according to a database study of almost 5,000 such operations.

"Following lobectomy for lung cancer, prolonged length of stay is a result of various operative and perioperative morbidities, and this is associated with higher overall morbidity and mortality compared to normal length of stay," said Dr. Cameron D. Wright of Massachusetts General Hospital, Boston.

"These predictors can be used by general thoracic surgeons who participate in the General Thoracic Database to provide risk-adjusted information to patients on their operative risk with lobectomy," he said in an interview.

The study presented at the annual meeting of the Society of Thoracic Surgeons, used the STS General Thoracic Database to identify all patients who underwent a lobectomy for lung cancer between January 2002 and June 2006.

Of the almost 5,000 lobectomies performed, 7% resulted in a prolonged length of stay (PLOS), defined as more than 14 days. The mean length of stay for patients with PLOS was 26 days, compared with 6 days for patients without PLOS.

"PLOS was associated with significantly more complications--3.4 events per day compared to 1.2 events," he noted.

For example, significantly more pulmonary complications, such as air leak for more than 5 days (36% vs. 8%), pneumonia (28% vs. 3%), acute respiratory distress syndrome (11% vs. 1%), and reintubation (33% vs. 1%), were noted in the patients with PLOS, Dr. Wright reported.

Mortality also increased in the PLOS group (10.8% vs. 0.71%), he said. Induction therapy, male gender, older age, the forced expiratory volume in 1 second percentage, an American Society of Anesthesiologists score of 3 or 4, and high Zubrod scores were all associated with significantly higher risk.

The study provides the first risk model for the General Thoracic Database, Dr. Wright said.

BY KATE JOHNSON Montreal Bureau
COPYRIGHT 2008 International Medical News Group
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2008 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:Pulmonary Medicine
Author:Johnson, Kate
Publication:Internal Medicine News
Article Type:Brief article
Geographic Code:1USA
Date:May 1, 2008
Previous Article:Radiofrequency ablation improves lung ca survival.
Next Article:Singulair: reports of suicidality under FDA review.

Related Articles
Amiodarone cuts atrial fib after lung surgery. (Pilot Study).
Few residents choose pulmonary/critical care.
Four risk factors identified for pulmonary complications.
Total thyroidectomy best for 1- to 2-cm tumors.
Myocardial infarction during left upper lobectomy in a patient with a LIMA graft.
Gene for deadly inherited lung disease identified.
The risk of postoperative pulmonary or pleural complications after aortic valve replacement is low in elderly patients: an observational study.
Duration of anaesthesia, type of surgery, respiratory co-morbidity, predicted V[O.sub.2]max and smoking predict postoperative pulmonary complications...

Terms of use | Privacy policy | Copyright © 2019 Farlex, Inc. | Feedback | For webmasters