Prevalence of and risk factors for pulmonary complications after curative resection in otherwise healthy elderly patients with early stage lung cancer
Abstract Background and objective The prevalence of lung cancer has been increasing in healthy elderly patients with preserved pulmonary function and without underlying lung diseases. We aimed to determine the prevalence of and risk factors for postoperative pulmonary complications (PPCs) in healthy...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12931-019-1087-x |
| _version_ | 1818528857470271488 |
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| author | Yunjoo Im Hye Yun Park Sumin Shin Sun Hye Shin Hyun Lee Joong Hyun Ahn Insuk Sohn Jong Ho Cho Hong Kwan Kim Jae Ill Zo Young Mog Shim Ho Yun Lee Jhingook Kim |
| author_facet | Yunjoo Im Hye Yun Park Sumin Shin Sun Hye Shin Hyun Lee Joong Hyun Ahn Insuk Sohn Jong Ho Cho Hong Kwan Kim Jae Ill Zo Young Mog Shim Ho Yun Lee Jhingook Kim |
| author_sort | Yunjoo Im |
| collection | DOAJ |
| description | Abstract Background and objective The prevalence of lung cancer has been increasing in healthy elderly patients with preserved pulmonary function and without underlying lung diseases. We aimed to determine the prevalence of and risk factors for postoperative pulmonary complications (PPCs) in healthy elderly patients with non-small cell lung cancer (NSCLC) to select optimal candidates for surgical resection in this subpopulation. Methods We included 488 patients older than 70 years with normal spirometry results who underwent curative resection for NSCLC (stage IA-IIB) between 2012 and 2016. Results The median (interquartile range) age of our cohort was 73 (71–76) years. Fifty-two patients (10.7%) had PPCs. Severe PPCs like acute respiratory distress syndrome, pneumonia, and respiratory failure had prevalences of 3.7, 3.7, and 1.4%, respectively. Compared to patients without PPCs, those with PPCs were more likely to be male and current smokers; have a lower body mass index (BMI), higher American Society of Anesthesiologists (ASA) classification, more interstitial lung abnormalities (ILAs), and higher emphysema index on computed tomography (CT); and have undergone pneumonectomy or bilobectomy (all p < 0.05). On multivariate analysis, ASA classification ≥3, lower BMI, ILA, and extent of resection were independently associated with PPC risk. The short-term all-cause mortality was significantly higher in patients with PPCs. Conclusions Curative resection for NSCLC in healthy elderly patients appeared feasible with 10% PPCs. ASA classification ≥3, lower BMI, presence of ILA on CT, and larger extent of resection are predictors of PPC development, which guide treatment decision-making in these patients. |
| first_indexed | 2024-12-11T06:55:28Z |
| format | Article |
| id | doaj.art-b9634ea1eab24cb3911cee764c59120f |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-11T06:55:28Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-b9634ea1eab24cb3911cee764c59120f2022-12-22T01:16:46ZengBMCRespiratory Research1465-993X2019-07-012011910.1186/s12931-019-1087-xPrevalence of and risk factors for pulmonary complications after curative resection in otherwise healthy elderly patients with early stage lung cancerYunjoo Im0Hye Yun Park1Sumin Shin2Sun Hye Shin3Hyun Lee4Joong Hyun Ahn5Insuk Sohn6Jong Ho Cho7Hong Kwan Kim8Jae Ill Zo9Young Mog Shim10Ho Yun Lee11Jhingook Kim12Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of MedicineStatistics and Data Center, Samsung Medical CenterStatistics and Data Center, Samsung Medical CenterDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Background and objective The prevalence of lung cancer has been increasing in healthy elderly patients with preserved pulmonary function and without underlying lung diseases. We aimed to determine the prevalence of and risk factors for postoperative pulmonary complications (PPCs) in healthy elderly patients with non-small cell lung cancer (NSCLC) to select optimal candidates for surgical resection in this subpopulation. Methods We included 488 patients older than 70 years with normal spirometry results who underwent curative resection for NSCLC (stage IA-IIB) between 2012 and 2016. Results The median (interquartile range) age of our cohort was 73 (71–76) years. Fifty-two patients (10.7%) had PPCs. Severe PPCs like acute respiratory distress syndrome, pneumonia, and respiratory failure had prevalences of 3.7, 3.7, and 1.4%, respectively. Compared to patients without PPCs, those with PPCs were more likely to be male and current smokers; have a lower body mass index (BMI), higher American Society of Anesthesiologists (ASA) classification, more interstitial lung abnormalities (ILAs), and higher emphysema index on computed tomography (CT); and have undergone pneumonectomy or bilobectomy (all p < 0.05). On multivariate analysis, ASA classification ≥3, lower BMI, ILA, and extent of resection were independently associated with PPC risk. The short-term all-cause mortality was significantly higher in patients with PPCs. Conclusions Curative resection for NSCLC in healthy elderly patients appeared feasible with 10% PPCs. ASA classification ≥3, lower BMI, presence of ILA on CT, and larger extent of resection are predictors of PPC development, which guide treatment decision-making in these patients.http://link.springer.com/article/10.1186/s12931-019-1087-xElderly patientsLung cancerPostoperative pulmonary complications |
| spellingShingle | Yunjoo Im Hye Yun Park Sumin Shin Sun Hye Shin Hyun Lee Joong Hyun Ahn Insuk Sohn Jong Ho Cho Hong Kwan Kim Jae Ill Zo Young Mog Shim Ho Yun Lee Jhingook Kim Prevalence of and risk factors for pulmonary complications after curative resection in otherwise healthy elderly patients with early stage lung cancer Respiratory Research Elderly patients Lung cancer Postoperative pulmonary complications |
| title | Prevalence of and risk factors for pulmonary complications after curative resection in otherwise healthy elderly patients with early stage lung cancer |
| title_full | Prevalence of and risk factors for pulmonary complications after curative resection in otherwise healthy elderly patients with early stage lung cancer |
| title_fullStr | Prevalence of and risk factors for pulmonary complications after curative resection in otherwise healthy elderly patients with early stage lung cancer |
| title_full_unstemmed | Prevalence of and risk factors for pulmonary complications after curative resection in otherwise healthy elderly patients with early stage lung cancer |
| title_short | Prevalence of and risk factors for pulmonary complications after curative resection in otherwise healthy elderly patients with early stage lung cancer |
| title_sort | prevalence of and risk factors for pulmonary complications after curative resection in otherwise healthy elderly patients with early stage lung cancer |
| topic | Elderly patients Lung cancer Postoperative pulmonary complications |
| url | http://link.springer.com/article/10.1186/s12931-019-1087-x |
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