Parameters:
(1) FEV1
(2) type of lung resection (wedge, bronchoplasic, major, extended)
(3) lesion requiring lung resection
(4) comorbidity score (modified Romano score, see Chapter 01)
Best prognosis (2% moderate complication, 2% major, 0% death):
(1) FEV1 >= 80% of predicted AND wedge resection AND benign or metastatic lung lesion
Good prognosis (24% moderate complication, 3% major, 2.5% death):
(1) FEV1 >= 80% of predicted AND major lung resection AND benign, malignant or metastatic lung lesion
(2) FEV1 < 80% of predicted AND wedge resection AND benign or metastatic lung lesion
Fair prognosis (34% moderate complication, 11% major, 8% death):
(1) comorbidity score < 4 AND FEV1 >= 80% of predicted AND extended lung resection for lung cancer
(2) FEV1 < 80% of predicted AND emphysema
(3) FEV1 < 80% of predicted AND lung cancer
Worst prognosis (39% moderate complication, 15% major, 24% death):
(1) FEV1 < 80% of predicted AND extended lung resection or bronchoplastic procedure AND benign, malignant or metastatic lung lesion
(2) comorbidity score >= 4 AND extended lung resection for lung cancer
where:
• Extended lung surgery refers to procedures involving pericardium, left atrium, superior vena cava, aorta, trachea, carina, diaphragm, parietal pleura, chest wall.
• A bronchoplastic procedure is a sleeve resection of a bronchus to preserve lung parenchyma.
• Moderate complications: prolonged air leak, atelectasis, postlobectomy space bleeding, cardiac arrhythmia, pneumonia, renal failure, pneumonia.
• Severe complications: ARDS, bronchopleural fistula, myocardial infarction, congestive heart failure
• Death: during same hospitalization or within 30 days after surgery
Lobectomy and pneumonectomy (major resection or extended procedures) were associated with a high risk of postoperative complications.
