HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ferguson, M. K. Articles by Little, A. G. Search for Related Content PubMed PubMed Citation Articles by Ferguson, M. K. Articles by Little, A. G.

The Journal of Thoracic and Cardiovascular Surgery, Vol 96, 894-900, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Diffusing capacity predicts morbidity and mortality after pulmonary resection

MK Ferguson, L Little, L Rizzo, KJ Popovich, GF Glonek, A Leff, D Manjoney and AG Little
Department of Surgery, University of Chicago Medical Center, Ill 60637.

Patients who are considered for major pulmonary resection are normally evaluated by spirometry and clinical assessment. Despite this, the morbidity and mortality rates are high after these operations. We retrospectively reviewed results of lung resection performed during a period of 7.5 years in 237 patients to identify other important predictors of morbidity and mortality. There were 144 male and 93 female patients with a mean age of 59.4 +/- 11.4 years. The indication for operation was lung cancer in 199 (76 stage I, 34 stage II, 89 stage IIIA-B), benign disease in 34, and metastatic disease from other primary tumors in four. Lobectomy or bilobectomy was performed in 164 patients and pneumonectomy in 73. Data on 38 preoperative and operative risk factors were correlated with information on 24 postoperative events grouped into four major categories: death, pulmonary complications, cardiovascular complications, and other problems. Logistic regression analysis and chi 2 analysis were used to identify the relationship of the preoperative risk factors to the grouped postoperative complications. The diffusing capacity of the lung for carbon monoxide was the most important predictor of mortality (p less 0.01) and was the sole predictor of postoperative pulmonary complications (p less than 0.005). This diffusing capacity can reveal the existence of emphysematous changes in the lung, even when spirometric values are acceptable, and it usually should be a part of the evaluation of patients being considered for pulmonary resection.

This article has been cited by other articles:

				M. K. Ferguson, J. Siddique, and T. Karrison Modeling major lung resection outcomes using classification trees and multiple imputation techniques Eur. J. Cardiothorac. Surg., November 1, 2008; 34(5): 1085 - 1089. [Abstract] [Full Text] [PDF]

				S. D. Cassivi, M. S. Allen, G. D. Vanderwaerdt, L. L. Ewoldt, M. E. Cordes, D. A. Wigle, F. C. Nichols, P. C. Pairolero, and C. Deschamps Patient-Centered Quality Indicators for Pulmonary Resection Ann. Thorac. Surg., September 1, 2008; 86(3): 927 - 932. [Abstract] [Full Text] [PDF]

				M. K. Ferguson and W. T. Vigneswaran Diffusing Capacity Predicts Morbidity After Lung Resection in Patients Without Obstructive Lung Disease Ann. Thorac. Surg., April 1, 2008; 85(4): 1158 - 1165. [Abstract] [Full Text] [PDF]

				M. K. Ferguson and W. T. Vigneswaran Changes in patient presentation and outcomes for major lung resection over three decades Eur. J. Cardiothorac. Surg., March 1, 2008; 33(3): 497 - 501. [Abstract] [Full Text] [PDF]

				P. W. Smith, H. Wang, L. M. Gazoni, K. R. Shen, T. M. Daniel, and D. R. Jones Obesity Does Not Increase Complications After Anatomic Resection for Non-Small Cell Lung Cancer Ann. Thorac. Surg., October 1, 2007; 84(4): 1098 - 1106. [Abstract] [Full Text] [PDF]

				G. L. Colice, S. Shafazand, J. P. Griffin, R. Keenan, and C. T. Bolliger Physiologic Evaluation of the Patient With Lung Cancer Being Considered for Resectional Surgery: ACCP Evidenced-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 161S - 177S. [Abstract] [Full Text] [PDF]

				A. Shaw Genetics of postoperative complications following thoracic surgery. Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2006; 10(4): 327 - 345. [Abstract] [PDF]

				C.S. Pramesh and R. C. Mistry Should carbon monoxide lung diffusion capacity (DLCO) measurement be mandatory before lung resection? Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 202 - 203. [Full Text] [PDF]

				G. Gould and A. Pearce Assessment of suitability for lung resection CEACCP, June 1, 2006; 6(3): 97 - 100. [Full Text] [PDF]

				A. Brunelli, M. A. Refai, M. Salati, A. Sabbatini, N. J. Morgan-Hughes, and G. Rocco Carbon monoxide lung diffusion capacity improves risk stratification in patients without airflow limitation: evidence for systematic measurement before lung resection. Eur. J. Cardiothorac. Surg., April 1, 2006; 29(4): 567 - 570. [Abstract] [Full Text] [PDF]

				R. Pellegrino, G. Viegi, V. Brusasco, R. O. Crapo, F. Burgos, R. Casaburi, A. Coates, C. P. M. van der Grinten, P. Gustafsson, J. Hankinson, et al. Interpretative strategies for lung function tests Eur. Respir. J., November 1, 2005; 26(5): 948 - 968. [Full Text] [PDF]

				J. Belda, M. Cavalcanti, M. Ferrer, M. Serra, J. Puig de la Bellacasa, E. Canalis, and A. Torres Bronchial Colonization and Postoperative Respiratory Infections in Patients Undergoing Lung Cancer Surgery Chest, September 1, 2005; 128(3): 1571 - 1579. [Abstract] [Full Text] [PDF]

				R. Berrisford, A. Brunelli, G. Rocco, T. Treasure, M. Utley, and On behalf of the Audit and guidelines committee of The European Thoracic Surgery Database project: modelling the risk of in-hospital death following lung resection Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 306 - 311. [Abstract] [Full Text] [PDF]

				R. M. Abou-Jawde, T. Mekhail, D. J. Adelstein, L. A. Rybicki, P. J. Mazzone, M. A. Caroll, and T. W. Rice Impact of Induction Concurrent Chemoradiotherapy on Pulmonary Function and Postoperative Acute Respiratory Complications in Esophageal Cancer Chest, July 1, 2005; 128(1): 250 - 255. [Abstract] [Full Text] [PDF]

				P. Magdeleinat, A. Seguin, M. Alifano, S. Boubia, and J.-F. Regnard Early and long-term results of lung resection for non-small-cell lung cancer in patients with severe ventilatory impairment Eur. J. Cardiothorac. Surg., June 1, 2005; 27(6): 1099 - 1105. [Abstract] [Full Text] [PDF]

				A. D. Shaw, A. A. Vaporciyan, X. Wu, T. M. King, M. R. Spitz, J. B. Putnam, and B. F. Dickey Inflammatory Gene Polymorphisms Influence Risk of Postoperative Morbidity After Lung Resection Ann. Thorac. Surg., May 1, 2005; 79(5): 1704 - 1710. [Abstract] [Full Text] [PDF]

				T. Win, A. Jackson, L. Sharples, A. M. Groves, F. C. Wells, A. J. Ritchie, and C. M. Laroche Relationship between pulmonary function and lung cancer surgical outcome Eur. Respir. J., April 1, 2005; 25(4): 594 - 599. [Abstract] [Full Text] [PDF]

				H. Matsuoka, W. Nishio, T. Sakamoto, H. Harada, and N. Tsubota Prediction of morbidity after lung resection with risk factors using treadmill exercise test Eur. J. Cardiothorac. Surg., September 1, 2004; 26(3): 480 - 482. [Abstract] [Full Text] [PDF]

				T. Iizasa, M. Suzuki, K. Yasufuku, A. Iyoda, M. Otsuji, S. Yoshida, Y. Sekine, K. Shibuya, Y. Saitoh, K. Hiroshima, et al. Preoperative pulmonary function as a prognostic factor for stage I non-small cell lung carcinoma Ann. Thorac. Surg., June 1, 2004; 77(6): 1896 - 1902. [Abstract] [Full Text] [PDF]

				S. A. Smulders, F. W. J. M. Smeenk, M. L. G. Janssen-Heijnen, and P. E. Postmus Actual and Predicted Postoperative Changes in Lung Function After Pneumonectomy: A Retrospective Analysis Chest, May 1, 2004; 125(5): 1735 - 1741. [Abstract] [Full Text] [PDF]

				J. R. Burke, I. G. Duarte, V. H. Thourani, and J. I. Miller Jr Preoperative risk assessment for marginal patients requiring pulmonary resection Ann. Thorac. Surg., November 1, 2003; 76(5): 1767 - 1773. [Abstract] [Full Text] [PDF]

				M. K. Ferguson and A. E. Durkin A comparison of three scoring systems for predicting complications after major lung resection Eur. J. Cardiothorac. Surg., January 1, 2003; 23(1): 35 - 42. [Abstract] [Full Text] [PDF]

				D. L. Miller, C. Deschamps, G. D. Jenkins, A. Bernard, M. S. Allen, and P. C. Pairolero Completion pneumonectomy: factors affecting operative mortality and cardiopulmonary morbidity Ann. Thorac. Surg., September 1, 2002; 74(3): 876 - 884. [Abstract] [Full Text] [PDF]

				J. R. Handy Jr, J. W. Asaph, L. Skokan, C. E. Reed, S. Koh, G. Brooks, E. C. Douville, A. C. Tsen, G. Y. Ott, and G. A. Silvestri What Happens to Patients Undergoing Lung Cancer Surgery?* : Outcomes and Quality of Life Before and After Surgery Chest, July 1, 2002; 122(1): 21 - 30. [Abstract] [Full Text] [PDF]

				A. Bernard, C. Deschamps, M. S. Allen, D. L. Miller, V. F. Trastek, G. D. Jenkins, and P. C. Pairolero Pneumonectomy for malignant disease: Factors affecting early morbidity and mortality J. Thorac. Cardiovasc. Surg., June 1, 2001; 121(6): 1076 - 1082. [Abstract] [Full Text] [PDF]

				British Thoracic Society, Society of Cardiothoracic Surgeons of Great Britai, and Ireland Working Party Guidelines on the selection of patients with lung cancer for surgery Thorax, February 1, 2001; 56(2): 89 - 108. [Full Text]

				H Uramoto, R Nakanishi, Y Fujino, H Imoto, M Takenoyama, T Yoshimatsu, T Oyama, T Osaki, and K Yasumoto Prediction of pulmonary complications after a lobectomy in patients with non-small cell lung cancer Thorax, January 1, 2001; 56(1): 59 - 61. [Abstract] [Full Text]

				S. Cykert, G. Kissling, and C. J. Hansen Patient Preferences Regarding Possible Outcomes of Lung Resection : What Outcomes Should Preoperative Evaluations Target? Chest, June 1, 2000; 117(6): 1551 - 1559. [Abstract] [Full Text] [PDF]

				A. Carretta, P. Zannini, A. Puglisi, G. Chiesa, A. Vanzulli, A. Bianchi, A. Fumagalli, and S. Bianco Improvement of pulmonary function after lobectomy for non-small cell lung cancer in emphysematous patients Eur. J. Cardiothorac. Surg., May 1, 1999; 15(5): 602 - 607. [Abstract] [Full Text] [PDF]

				J. Wang, J. Olak, R. E. Ultmann, and M. K. Ferguson Assessment of pulmonary complications after lung resection Ann. Thorac. Surg., May 1, 1999; 67(5): 1444 - 1447. [Abstract] [Full Text] [PDF]

				M. K. Ferguson Preoperative Assessment of Pulmonary Risk Chest, May 1, 1999; 115(suppl_2): 58S - 63S. [Abstract] [Full Text] [PDF]

				A-M Nugent, I C Steele, A M Carragher, K McManus, J A McGuigan, J R P Gibbons, M S Riley, and D P Nicholls Effect of thoracotomy and lung resection on exercise capacity in patients with lung cancer Thorax, April 1, 1999; 54(4): 334 - 338. [Abstract] [Full Text]

				J. Wang, J. Olak, and M. K. Ferguson DIFFUSING CAPACITY PREDICTS OPERATIVE MORTALITY BUT NOT LONG-TERM SURVIVAL AFTER RESECTION FOR LUNG CANCER J. Thorac. Cardiovasc. Surg., March 1, 1999; 117(3): 581 - 587. [Abstract] [Full Text] [PDF]

				S. R. DeMeester, G. A. Patterson, R. S. Sundaresan, and J. D. Cooper Lobectomy Combined With Volume Reduction For Patients With Lung Cancer And Advanced Emphysema J. Thorac. Cardiovasc. Surg., March 1, 1998; 115(3): 681 - 685. [Abstract] [Full Text]

				M. Ninan, K. E. Sommers, R. J. Landreneau, R. J. Weyant, J. Tobias, J. D. Luketich, P. F. Ferson, and R. J. Keenan Standardized Exercise Oximetry Predicts Postpneumonectomy Outcome Ann. Thorac. Surg., August 1, 1997; 64(2): 328 - 332. [Abstract] [Full Text]

				C. J. Knott-Craig, C. E. Howell, B. D. Parsons, S. M. Paulsen, B. R. Brown, and R. C. Elkins Improved Results in the Management of Surgical Candidates With Lung Cancer Ann. Thorac. Surg., May 1, 1997; 63(5): 1405 - 1409. [Abstract] [Full Text]

				R. J. Cerfolio, M. S. Allen, V. F. Trastek, C. Deschamps, P. D. Scanlon, and P. C. Pairolero Lung Resection in Patients With Compromised Pulmonary Function Ann. Thorac. Surg., August 1, 1996; 62(2): 348 - 351. [Abstract] [Full Text]

				S. Hazelrigg, T. Boley, J. Henkle, C. Lawyer, D. Johnstone, K. Naunheim, C. Keller, R. Keenan, R. Landreneau, F. Sciurba, et al. THORACOSCOPIC LASER BULLECTOMY: A PROSPECTIVE STUDY WITH THREE-MONTH RESULTS J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 319 - 327. [Abstract] [Full Text]

				M. Okada, M. Okada, N. Ishii, C. Yamashita, T. Sugimoto, K. Okada, H. Yamagishi, T. Yamashita, and H. Matsuda RIGHT VENTRICULAR EJECTION FRACTION IN THE PREOPERATIVE RISK EVALUATION OF CANDIDATES FOR PULMONARY RESECTION J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 364 - 370. [Abstract] [Full Text]

				V. Rao, T. R. J. Todd, A. Kuus, K. J. Buth, and F. G. Pearson Exercise Oximetry Versus Spirometry in the Assessment of Risk Prior to Lung Resection Ann. Thorac. Surg., September 1, 1995; 60(3): 603 - 608. [Abstract] [Full Text]

				M. K. Ferguson, L. B. Reeder, and R. Mick Optimizing selection of patients for major lung resection J. Thorac. Cardiovasc. Surg., February 1, 1995; 109(2): 275 - 283. [Abstract] [Full Text]