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The Annals of Thoracic Surgery, Vol 54, 84-88, Copyright © 1992 by The Society of Thoracic Surgeons
RL Patel, ER Townsend and SW Fountain
We have retrospectively reviewed hospital records of 197 consecutive
patients undergoing pneumonectomy for neoplastic disease between 1985 and
1990 to identify predictors of outcome. Seventeen of the 197 patients died
during their hospital stay (8.6%; 95% confidence intervals, 6.7% to 11.2%).
The most significant predictors of in- hospital mortality were presence of
coexisting medical conditions (p less than 0.001), respiratory function
tests showing an obstructive picture with a forced expiratory volume in 1
second/forced vital capacity ratio of less than 0.55 (p less than 0.001),
24-hour fluid replacement of more than 3 L (p less than 0.05),
postoperative pulmonary edema (p less than 0.001), respiratory tract
infection with positive sputum culture (p less than 0.01), postoperative
renal failure (p less than 0.001), and cardiac arrhythmias (p less than
0.001). There were 232 postoperative management, problems occurring in 197
patients. The most significant predictors of postoperative morbidity were
continued cigarette smoking up to the time of operation (p less than 0.05),
perioperative blood loss or more than 2 L (p less than 0.05), and infusion
of more than 3 L of fluid in the first 24 hours (p less than 0.05).
Although retrospective analyses must be interpreted with caution, this
study has identified preoperative and perioperative factors associated with
in-hospital morbidity and mortality after pneumonectomy.
ARTICLES
Elective pneumonectomy: factors associated with morbidity and operative mortality
Department of Thoracic Surgery, Harefield Hospital, United Kingdom.
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