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The Annals of Thoracic Surgery, Vol 40, 349-352, Copyright © 1985 by The Society of Thoracic Surgeons
BA Keagy, ME Lores, PJ Starek, GF Murray, CL Lucas and BR Wilcox
Periodic review of clinical results is essential to ensure that high-
quality patient care is maintained. To that end, we reviewed the morbidity
and operative mortality in a consecutive series of 369 pulmonary
lobectomies performed between January 1, 1970, and December 31, 1983. There
were 251 male and 118 female patients with a mean age of 50.6 years. The
thirty-day operative mortality was 2.2% (8/369), with 6 of these deaths
related primarily to respiratory insufficiency. Two hundred twenty-four
postoperative management problems occurred in 151 patients and included
arrhythmia, air leak, pneumothorax, respiratory difficulties, postoperative
bleeding, pleural effusion, wound infection, myocardial infarction,
pulmonary embolus, empyema, bronchial stump leak, and lobar gangrene.
Multiple factors were related to the occurrence of postoperative morbidity
and mortality using both chi-square analysis to examine each individual
item and discriminant analysis to evaluate their interaction. Chi-square
tabulation showed no difference in the occurrence of major postoperative
complications (p greater than 0.05) related to the side of operation, an
abnormal preoperative electrocardiogram, a forced vital capacity of 2.8
liters or less, a one-second forced expiratory volume (FEV1) of less than
1.7 liters, an oxygen tension of less than 60 mm Hg, or the seniority of
the surgeon (resident versus attending). An increased number of
complications (p less than 0.05) was found in male patients, in patients
operated on for carcinoma, and in patients older than 60 years. Stepwise
discriminant analysis included FEV1 as a significant predictor of
postoperative complications.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Elective pulmonary lobectomy: factors associated with morbidity and operative mortality
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