PAL linked to pulmonary complication risk after resection

  • Attaar A & al.
  • Ann Surg
  • 15 Feb 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Prolonged air leak (PAL) after pulmonary resection significantly increased the risk for chest tube reinsertion or discharge with chest tube, 30-day readmission, and length of stay (LOS), but not cardiac complications, unexpected ICU admission, or 30-day mortality.

Why this matters

  • Although previous studies showed an increased risk for these complications in patients who develop PAL, it was unclear whether they were a direct result of PAL or attributable to baseline characteristics.

Study design

  • 2280 patients from the Society of Thoracic Surgeons General Thoracic Surgery Database underwent pulmonary resection for suspected lung cancer from January 2009 to June 2014.
  • Funding: NIH.

Key results

  • PAL incidence was 8.3%.
  • After propensity score weighting, PAL was significantly associated with an increased risk for empyema (OR, 8.39; P<.001 unexpected return to the operating room los p readmission discharge with chest tube and pneumothorax reinsertion>
  • PAL was not significantly associated with increased risk for cardiac complications, 30-day mortality, or unexpected ICU admission.

Limitations

  • Possible unmeasured confounders.