TITLE

Association of body mass index and outcomes after major lung resection†

AUTHOR(S)
Ferguson, Mark K.; Im, Hae Kyung; Watson, Sydeaka; Johnson, Elizabeth; Wigfield, Christopher H.; Vigneswaran, Wickii T.
PUB. DATE
April 2014
SOURCE
European Journal of Cardio-Thoracic Surgery;Apr2014, Vol. 45 Issue 4, pe94
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES Obesity has been thought to predispose patients to excess morbidity after lung resection because of decreased diaphragm excursion, reduced lung volumes and relative immobility. We assessed the relationship of body mass index (BMI) to acute outcomes after major lung resection. METHODS Information from our database of lung resections was evaluated for the period 1980–2011. Univariate analysis for adverse events (pulmonary, cardiovascular, other and overall) was used to select variables for inclusion in multivariate logistic regression analyses. Missing values were imputed. BMI was categorized as underweight (<18.5), normal (18.5–24.9), overweight (25–29.9), obese (30–34.9) and very obese (≥35). RESULTS Among 1369 patients, there were 703 males (51%) and the mean age was 62 ± 11 years. Complications included the following: pulmonary 12%, cardiovascular 15%, other 16%, mortality 5% and any 29%. The incidence of complications decreased during each decade of study (40, 30, 26, 20%; P < 0.0001) and the incidence of obese/very obese increased during the same intervals (11, 22, 30, 25%; P = 0.0007). Adjusting for age, performance status, coronary artery disease, smoking status, diffusing capacity of the lung for carbon monoxide, forced expiratory volume in 1 s and operation year, being overweight/obese/very obese did not increase the risk of postoperative complications in any category. In fact, patients in this group showed a lower rate of cardiovascular complications than those with BMI ≤ 25 (odds ratio (OR): 0.72; 95% confidence interval (CI): 0.51–1.00; P = 0.048). However, being underweight was importantly associated with an increased risk of pulmonary complications (OR: 2.5; 95% CI: 1.3–4.9; P = 0.0087) and of operative mortality (OR: 2.96; 95% CI: 1.28–6.86; P = 0.011). CONCLUSION Being overweight or obese does not increase the risk of complications after major lung resection. In contrast, patients who are underweight are at significantly increased risk of pulmonary complications and mortality. Knowledge of the relationship of BMI to perioperative risk for major lung resection is essential in proper risk stratification.
ACCESSION #
94998412

 

Related Articles

  • Computed tomography-defined functional lung volume after segmentectomy versus lobectomy. Ueda, Kazuhiro; Tanaka, Toshiki; Hayashi, Masataro; Li, Tao-Sheng; Tanaka, Nobuyuki; Hamano, Kimikazu // European Journal of Cardio-Thoracic Surgery;Jun2010, Vol. 37 Issue 6, p1433 

    Abstract: Objective: Lung segmentectomy reduces the extent of resection required for lobectomy, but its resulting clinical benefits remain controversial. Methods: Forty patients who underwent segmentectomy for stage I lung cancer over a 5-year period were matched to 40 patients who underwent...

  • National trends in lung cancer surgery. Strand, Trond-Eirik; Bartnes, Kristian; Rostad, Hans // European Journal of Cardio-Thoracic Surgery;Aug2012, Vol. 42 Issue 2, p355 

    OBJECTIVES Trends in lung cancer surgery may reveal potential for improvement and are important for planning by care providers. METHODS Using data from the Cancer Registry of Norway, we analysed the outcomes of lung cancer surgery during the periods of 1994–95, 2000–01 and...

  • Pulmonary arterial enlargement predicts cardiopulmonary complications after pulmonary resection for lung cancer: a retrospective cohort study. Keisuke Asakura; Shota Mitsuboshi; Makoto Tsuji; Hiroyuki Sakamaki; Sotaro Otake; Shinsaku Matsuda; Kaoru Kaseda; Kenichi Watanabe // Journal of Cardiothoracic Surgery;9/10/2015, Vol. 10 Issue 1, p1 

    Background: The finding of pulmonary arterial enlargement on computed tomography has been reported to be associated with pulmonary hypertension. On the other hand, pulmonary hypertension is a known risk factor for thoracic surgery. We investigated whether pulmonary arterial enlargement predicts...

  • Bronchovascular reconstructions for lung cancer: improvements over time. Maurizi, Giulio; Rendina, Erino Angelo // European Journal of Cardio-Thoracic Surgery;Jan2016, Vol. 49 Issue 1, p306 

    The authors discuss developments related to bronchovascular reconstructions for lung cancer treatment. They describe successful techniques that have been developed pertaining to the prevention of major complications and the reconstruction of the pulmonary artery. They also examine the results of...

  • Descriptive analysis of and overall survival after surgical treatment of lung metastases. Balestro Poletti, Giana; Contrera Toro, Ivan Felizardo; Ferreira Alves, Thais; Martins Miranda, Eliana Cristina; Teixeira Seabra, José Cláudio; Kalaf Mussi, Ricardo // Jornal Brasileiro de Pneumologia;nov/dez2013, Vol. 39 Issue 6, p650 

    Objective: To describe demographic characteristics, surgical results, postoperative complications, and overall survival rates in surgically treated patients with lung metastases. Methods: This was a retrospective analysis of 119 patients who underwent a total of 154 lung metastasis resections...

  • Surgical outcome of patients with lung cancer involving the left atrium. Tsukioka, Takuma; Takahama, Makoto; Nakajima, Ryu; Kimura, Michitaka; Inoue, Hidetoshi; Yamamoto, Ryoji // International Journal of Clinical Oncology;Dec2016, Vol. 21 Issue 6, p1046 

    Background: Pulmonary and left atrial resection is not yet an established treatment for patients with primary lung cancer involving the left atrium. We investigated the clinical course of patients with primary lung cancer involving the left atrium who were treated with pulmonary resection and...

  • Outcome of Surgical Resection as a First Line Therapy in T3 Non-small Cell Lung Cancer Patients. Takenaka, Tomoyoshi; Katsura, Masakazu; Shikada, Yasunori; Takeo, Sadanori // World Journal of Surgery;Nov2013, Vol. 37 Issue 11, p2574 

    Background: The T3 category of the 7th Edition of the TNM classification of non-small cell lung cancer (NSCLC) has added two factors that do not appear in the 6th Edition, large tumor size (>7 cm) and pulmonary metastasis of the same lobe. These factors are considered to have different...

  • An aggregate score to predict the risk of large pleural effusion after pulmonary lobectomy. Hristova, Ralitsa; Pompili, Cecilia; Begum, Sofina; Salati, Michele; Kefaloyannis, Manos; Tentzeris, Vasileios; Papagiannopoulos, Kostas; Brunelli, Alessandro // European Journal of Cardio-Thoracic Surgery;Jul2015, Vol. 48 Issue 1, p72 

    OBJECTIVES: The volume of pleural effusion is one of the determinants of chest drain removal following pulmonary resection. Recent research suggests that values up to 400 ml/day are safe. The objective of this study was to develop an aggregate risk score to identify patients at higher risk of...

  • Clinical outcome of resected solid-type small-sized c-stage IA non-small cell lung cancer. Inoue, Masayoshi; Minami, Masato; Sawabata, Noriyoshi; Utsumi, Tomoki; Kadota, Yoshihisa; Shigemura, Norihisa; Okumura, Meinoshin // European Journal of Cardio-Thoracic Surgery;Jun2010, Vol. 37 Issue 6, p1445 

    Abstract: Background: The chances of pulmonary resection for small-sized lung cancer have increased because of the development of thin-slice computed tomography (CT). Though sublobar resection could be indicated for ground glass opacity (GGO)-dominant adenocarcinoma with low-grade behaviour, the...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics