Analytic Morphomics Are Related to Outcomes After Lung Volume Reduction Surgery.

Authors

• Jules Lin
• William B Weir
• Tyler Grenda
• Peng Zhang
• Brian A Derstine
• Binu Enchakalody
• Joshua Underhill
• Rishindra M Reddy
• Andrew C Chang
• Stewart C Wang

Publication/Presentation Date

1-1-2022

Abstract

:Lung volume reduction surgery continues to have a high morbidity despite National Emphysema Treatment Trial selection criteria. This study evaluated the association between analytic morphomics on chest computed tomography scans and outcomes after lung volume reduction surgery. In a retrospective review of 85 lung volume reduction surgery patients from 1998-2013, dorsal muscle group area, subcutaneous and visceral fat area, and bone mineral density were assessed using analytic morphomics. Lung density was divided into five levels of increasing density (Lung density 1, emphysema; 2, normal lung; 4-5, scarring). Outcomes including survival, hospital length of stay, readmission at 30 days, and pulmonary complications were analyzed using univariate and multivariable techniques. Pulmonary complications developed in 27.1% (23/85). Mortality at 90 days was 9.4% (8/85). On multivariable analysis, lower bone mineral density (Odds ratio 0.61; 95% confidence interval 0.39-0.95) was associated with decreased survival, longer length of stay (0.83; 0.77-0.89), and readmissions (0.39; 0.15-1.00). Higher lung density 5:lung density 2 volume (1.84; 1.05-3.23), possibly due to scarring, was associated with pulmonary complications and longer length of stay (1.32; 1.23-1.41) while lower subcutaneous fat area:height was associated with readmissions which may reflect decreased metabolic reserve (0.35; 0.13-0.93). Patients with signs of frailty including lower bone mineral density may be at increased risk of adverse outcomes including decreased survival after lung volume reduction surgery. The results of this hypothesis-generating study will need to be confirmed in larger, multicenter trials to determine whether analytic morphomics can improve risk stratification and patient selection.

Volume

34

Issue

3

First Page

1084

Last Page

1090

ISSN

1532-9488

Published In/Presented At

Lin, J., Weir, W. B., Grenda, T., Zhang, P., Derstine, B. A., Enchakalody, B., Underhill, J., Reddy, R. M., Chang, A. C., & Wang, S. C. (2022). Analytic Morphomics Are Related to Outcomes After Lung Volume Reduction Surgery. Seminars in thoracic and cardiovascular surgery, 34(3), 1084–1090. https://doi.org/10.1053/j.semtcvs.2021.06.015

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

34166813

Department(s)

Administration and Leadership

Document Type

Article