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Risk factors and outcomes of prolonged air leak after pulmonary resections.

ABSTRACT: Purpose:Prolonged air leak (PAL) is a challenging complication in thoracic surgery. The aim of this study was to analyze the incidence, risk factors, and outcomes of PAL. Methods:We retrospectively analyzed 319 patients treated in a single center submitted to lobectomy, bilobectomy, segmentectomy, and wedge resections from January 2012 until August 2015. PAL was defined as air leak lasting more than 7 days after surgery. Results:The incidence of PAL was 14.7%. Bronchial obstruction (p?

SUBMITTER: Pischik VG

PROVIDER: S-EPMC7525848 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Risk factors and outcomes of prolonged air leak after pulmonary resections.

Pischik Vadim Grigoryevich VG Maslak Olga Sergeevna OS Obornev Aleksandr Dmitrievich AD Zinchenko Eugeniy Igorevich EI Kovalenko Aleksandr Igorevich AI

Indian journal of thoracic and cardiovascular surgery 20190508 4

<h4>Purpose</h4>Prolonged air leak (PAL) is a challenging complication in thoracic surgery. The aim of this study was to analyze the incidence, risk factors, and outcomes of PAL.<h4>Methods</h4>We retrospectively analyzed 319 patients treated in a single center submitted to lobectomy, bilobectomy, segmentectomy, and wedge resections from January 2012 until August 2015. PAL was defined as air leak lasting more than 7 days after surgery.<h4>Results</h4>The incidence of PAL was 14.7%. Bronchial obs ...[more]

PMID: 33061052

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Project description:Background Prolonged air leak (PAL) remains one of the most frequent postoperative complications after pulmonary resection. This study aimed to develop a predictive nomogram to estimate the risk of PAL for individual patients after minimally invasive pulmonary resection. Methods Patients who underwent minimally invasive pulmonary resection for either benign or malignant lung tumors between January 2020 and December 2021 were included. All eligible patients were randomly assigned to the training cohort or validation cohort at a 3:1 ratio. Univariate and multivariate logistic regression were performed to identify independent risk factors. All independent risk factors were incorporated to establish a predictive model and nomogram, and a web-based dynamic nomogram was then built based on the logistic regression model. Nomogram discrimination was assessed using the receiver operating characteristic (ROC) curve. The calibration power was evaluated using the Hosmer-Lemeshow test and calibration curves. The nomogram was also evaluated for clinical utility by the decision curve analysis (DCA). Results A total of 2213 patients were finally enrolled in this study, among whom, 341 cases (15.4%) were confirmed to have PAL. The following eight independent risk factors were identified through logistic regression: age, body mass index (BMI), smoking history, percentage of the predicted value for forced expiratory volume in 1 second (FEV1% predicted), surgical procedure, surgical range, operation side, operation duration. The area under the ROC curve (AUC) was 0.7315 [95% confidence interval (CI): 0.6979–0.7651] for the training cohort and 0.7325 (95% CI: 0.6743–0.7906) for the validation cohort. The P values of the Hosmer-Lemeshow test were 0.388 and 0.577 for the training and validation cohorts, respectively, with well-fitted calibration curves. The DCA demonstrated that the nomogram was clinically useful. An operation interface on a web page (https://lirongyangql.shinyapps.io/PAL_DynNom/) was built to improve the clinical utility of the nomogram. Conclusion The nomogram achieved good predictive performance for PAL after minimally invasive pulmonary resection. Patients at high risk of PAL could be identified using this nomogram, and thus some preventive measures could be adopted in advance. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02716-w.

Dataset Information

Risk factors and outcomes of prolonged air leak after pulmonary resections.

Publications

Risk factors and outcomes of prolonged air leak after pulmonary resections.

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