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Mortality risk factors in lobectomies: Single-institution study Cover

Mortality risk factors in lobectomies: Single-institution study

Open Access
|Dec 2019

Figures & Tables

Characteristics of postoperative pleural drainage in the study group

Analysed factorAll: 192 No. (%)Postoperative deathp
No 187 (97.4%)Yes 5 (2.6%)
Drainage Day 1 (mL)497.92 ± 226.91492.51 ± 221.00700 ± 367.420.043
Drainage Day 1 >650 mL (cut-off)37 (19.3%)34 (18.2%)3 (60.0%)0.050
Drainage Day 2 (mL)273.70 ± 139.70268.72 ± 128.67460.00 ± 343.510.002
Drainage Day 2 >550 mL (cut-off)9 (4.7%)7 (3.7%)2 (40%)0.007
Drainage Day 1 + Day 2 >950 mL (cut-off)37 (19.3%)34 (18.2%)3 (60.0%)0.050
Haemorrhage Day 1 >1,000 mL12 (6.3%)11 (5.9%)1 (20.0%)0.278
Haemorrhage Day 1 + Day 2 >1,500 mL13 (6.8%)11 (5.9%)2 (40.0%)0.038

The impact of RFs on mortality in lobectomies as found in multivariate analysis

Variable/RFExp (B)Sig.95% CI for Exp (B)
LowerUpper
Thrombocytosis7.410.1420.51107.77
COPD2.450.5430.1444.16
Digestive conditions4.890.25660.3275.69
Neoadjuvant chemotherapy2.030.6150.1331.69
TB11.390.0980.64203.35
Drainage Day 2 >550 mL2.630.5800.15221.42
Haemorrhage >1,500 mL5.840.3140.15221.42

Pathological characteristics of patients having undergone lobectomy

Analysed factorAll: 192 No. (%)Postoperative deathp
No 187 (97.4%)Yes 5 (2.6%)
Associated infectionsNonspecific40 (20.8%)39 (20.9%)1 (20.0%)0.001
TB13 (6.8%)11 (5.9%)2 (40.0%)
No infection139 (72.4%)137 (73.3%)2 (40%)
TBWithout TB179 (93.2%)176 (94.1%)3 (60%)0.036
With TB13 (6.8%)11 (5.9%)2 (40.0%)
Pathological diagnosisAbscess10 (5.2%)10 (5.3%)0 (0.0%)0.155
Benign3 (1.6%)3 (1.6%)0 (0.0%)
Bronchiectasis3 (1.6%)3 (1.6%)0 (0.0%)
Adenocarcinoma68 (35.4%)65 (34.8%)3 (60.0%)
Carcinoma43 (22.4%)43 (23.0%)0 (0.0%)
Other NSCLC27 (14.1%)27 (14.4%)0 (0.0%)
Sarcoma9 (4.7%)9 (4.8%)0 (0.0%)
Carcinoid8 (4.2%)8 (4.7%)0 (0.0%)
TB11 (4.2%)9 (4.8%2 (18.8%)
Other rare findings9 (4.7%)9 (4.8%)0 (0.0%)
Malignant conditions157 (81.8%)154 (82.4%)3 (60%)0.225
Benign conditions35 (18.2%)33 (17.6%)2 (40.0%)0.225
TNM 7 stagesIA11 (5.7%)9 (4.8%)2 (40.0%)0.054
IB31 (16.1%)31 (16.6%)0 (0.0%)
IIA36 (18.8%)36 (19.3%)0 (0.0%)
IIB35 (18.2%)34 (18.2%)1 (20.0%)
IIIA26 (13.5%)26 (13.9%)0 (0.0%)
IIIB7 (3.6%)7 (3.7%)0 (0.0%)
IV4 (2.1%)4 (2.1%)0 (0.0%)

Functional and laboratory characteristics of patients

Analysed factorAll: 192 No. (%)Postoperative deathp
No 187 (97.4%)Yes 5 (2.6%)
Age (years)57.48 ± 11.1157.35 ± 10.9962.40 ± 15.580.317
Male sex139 (72.4%)134 (71.7%)5 (100%)0.325
Smoking [>20 packs per year (P/Y)]156 (81.3%)152 (81.3%)4 (80.0%)1.000
Total lung capacity% (TLC%)77.73 ± 14.1284.42 ± 14.8577.55 ± 14.100.284
FEV1%84.34 ± 16.6880.04 ± 15.2684.45 ± 16.750.561
FEV25–75%74.43 ± 28.4560.20 ± 29.2274.82 ± 28.410.258
Oxygen saturation (arterial blood) (SaO2)95.55 ± 2.8996.64 ± 1.1395.52 ± 2.920.393
Partial pressure of oxygen in arterial blood (PaO2)81.35 ± 17.9384.40 ± 8.4081.27 ± 18.120.701
Partial pressure of carbon dioxide in arterial blood (PaCO2)39.04 ± 5.2240.52 ± 2.6039.00 ± 5.270.522
pH7.38 ± 0.057.37 ± 0.037.38 ± 0.050.581
Pulmonary artery pressures (PAPs)28.74 ± 6.1232.40 ± 2.5128.65 ± 6.160.176
Left ventricle ejection fraction% (LVEF%)55.09 ± 5.6754.60 ± 4.4555.10 ± 5.710.846
Leucocytosis77 (40.1%)73 (39.0%)4 (80.0%)0.159
Anaemia103 (53.6%)99 (52.9%)4 (80.0%)0.375
Thrombocytosis20 (10.4%)17 (9.1%)3 (60.0%)0.009
Inflammatory markers117 (60.9%)114 (61.0%)3 (60.0%)1.000

Characteristics of the anaesthesia and surgery

Analysed factorAll: 192 No. (%)Postoperative deathp
No 187 (97.4%)Yes 5 (2.6%)
Previous thoracotomy7 (3.6%)7 (3.7%)0 (0.0%)1.000
Emergency lobectomy6 (3.1%)5 (2.7%)1 (20%)0.148
ASAI8 (4.2%)8 (4.3%)0 (0.0%)<0.001
II79 (41.1%)78 (41.7%)1 (20.0%)
III104 (54.2%)101 (54.0%)3 (60.0%)
IV1 (0.5%)0 (0.0%)1 (20.0%)
LobectomyRight upper lobe (RUL)49 (25.5%)47 (25.1%)2 (40.0%)0.188
Medium lobe (ML)12 (6.3%)12 (6.4%)0 (0.0%)
Right lower lobe (RLL)44 (22.9%)41 (21.9%)3 (60.0%)
Left upper lobe (LUL)47 (24.5%)47 (25.1%)0 (0.0%)
Left lower lobe (LLL)40 (20.8%)40 (21.4%)0 (0.0%)
Duration of intervention3.19 ± 1.023.20 ± 1.033.02 ± 1.040.704

Comorbidities of lobectomy patients

Analysed factorAll: 192 No. (%)Postoperative deathp
No 187 (97.4%)Yes 5 (2.6%)
Cardiovascular conditions98 (51.0%)95 (50.8%)3 (60.0%)1.000
Diastolic dysfunction46 (24.0%)44 (23.5%)2 (40.0%)0.595
Respiratory disease79 (41.1%)75 (40.1%)4 (80.0%)0.161
COPD65 (33.9%)61 (32.6%)4 (80.0%)0.046
Neuro-psychiatric conditions16 (8.3%)16 (8.6%)0 (0.0%)1.000
Metabolic diseases41 (21.4%)41 (21.9%)0 (0.0%)0.586
Diabetes mellitus15 (7.8%)15 (8.0%)0 (0.0%)1.000
Urogenital conditions14 (7.3%)13 (7.0%)1 (20%)0.318
Kidney failure9 (4.7%)9 (4.8%)0 (0.0%)1.000
Digestive conditions36 (18.8%)33 (17.6%)3 (60.0%)0.046
Osteoarticular conditions15 (7.8%)15 (8.0%)0 (0.0%)1.000
Skin diseases6 (3.1%)6 (3.2%)0 (0.0%)1.000
Associated cancers19 (9.9%)18 (9.6%)1 (20.0%)0.410
Number of comorbidities1.81 ± 1.7171.80 ± 1.7232.40 ± 1.5170.440
Neoadjuvant chemotherapy55 (28.6%)51 (27.3%)4 (80%)0.024
Preoperative radiotherapy5 (2.6%)5 (2.7%)0 (0.0%)1.000
DOI: https://doi.org/10.2478/pneum-2019-0025 | Journal eISSN: 2247-059X | Journal ISSN: 2067-2993
Language: English
Page range: 130 - 137
Published on: Dec 9, 2019
Published by: Romanian Society of Pneumology
In partnership with: Paradigm Publishing Services
Publication frequency: Volume open

© 2019 Bogdan I. Popovici, Dana Matei, Anca Daniela Farcas, Milena Man, Cornelia Popovici, Romeo Chira, Cornel Iancu, published by Romanian Society of Pneumology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.