Risk analysis for thoracoscopic lung volume reduction: a multi-institutional experience.
Publication/Presentation Date
6-1-2000
Abstract
OBJECTIVE: Most reports of thoracoscopic lung volume reduction (TLVR) are relatively small and early experiences from a single institution, factors which limit both the statistical validity and the applicability to the population at large. In order to address these shortcomings we undertook an analysis of the TLVR experience at five separate institutions to assess operative morbidity and identify predictors of mortality.
METHODS: Questionnaires were sent to four groups of surgical investigators at five institutions actively performing TLVR. Data was requested regarding preoperative, operative and postoperative parameters. Twenty-five potential predictors of mortality were analyzed and seven proved to be at least marginally significant (P
RESULTS: The 682 patients (415 males, 267 females, mean age 64.0 years) underwent unilateral (410) or bilateral (272) TLVRs. Overall, operative mortality was 6% with half of the deaths resulting from respiratory causes. The remaining patients were discharged to home (88%), a rehabilitation facility (4%) or a ventilator facility (2%). There were 25 perioperative factors chosen representing clinically important indices such as spirometry, oxygenation, functional status, clinical and demographic variables. Univariate analysis identified seven variables as predictors of mortality (P
CONCLUSION: This experience suggests that unilateral and bilateral lung volume reduction procedure can be performed with acceptable morbidity and mortality. Although age, gender, exercise capacity and the procedure performed are all independent predictors of mortality, the risk of operative death did not appear excessive in this fragile patient subset.
Volume
17
Issue
6
First Page
673
Last Page
679
ISSN
1010-7940
Published In/Presented At
Naunheim, K. S., Hazelrigg, S. R., Kaiser, L. R., Keenan, R. J., Bavaria, J. E., Landreneau, R. J., Osterloh, J., & Keller, C. A. (2000). Risk analysis for thoracoscopic lung volume reduction: a multi-institutional experience. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 17(6), 673–679. https://doi.org/10.1016/s1010-7940(00)00450-4
Disciplines
Medicine and Health Sciences
PubMedID
10856858
Department(s)
Department of Surgery
Document Type
Article