Szekeley et al identified preoperative risk factors associated with death or prolonged hospitalization in patients with COPD who underwent bilateral lung volume reduction surgery. This can help identify patients who may not be surgical candidates and to provide better informed consent to patients. The authors are from Massachusetts General Hospital.


Patient selection: emphysema and bilateral lung volume reduction surgery


Unacceptable outcomes used as targets:

(1) death

(2) hospital course > 21 days


Preoperative risk factors associated with complications:

(1) resting PaCO2 >= 45 mm Hg

(2) 6 minute walking test < 200 meters before pulmonary rehabilitation

(3) 6 minute walking test < 200 meters after pulmonary rehabilitation


The presence of 1 or more of the preoperative risk factors were associated with unacceptable postoperative outcomes.


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