P2.05-13 Impact of Diffusing Capacity for Postoperative Pulmonary Complications in Patients Without Obstructive Pulmonary Disease

Abstract

This study evaluated the impact of diffusing capacity of the lungs for carbon monoxide (DLco) on postoperative pulmonary complications (PPCs) after lung resection in patients without obstructive pulmonary disease We retrospectively reviewed non-small cell lung cancer patients undergoing anatomical lung resection without induction treatment between 2015 and 2016. Of these, 1233 patients without obstructive pulmonary disease were included in the study. We considered the following PPCs as study outcomes: pneumonia, acute respiratory distress syndrome (ARDS), significant atelectasis, empyema, bronchopleural fistula, prolonged air leakage and pneumothorax. The independent effects of DLco on PPCs were evaluated using multivariate logistic regression. Models were adjusted for age, sex, smoking status, comorbidity, histology and type of surgery. Twenty three percentage of patients showed the decrement of pred % of DLco less than 80. A total of 104 patients (8.4%) developed at least one PPC. More PPCs were occurred in the patients with impaired DLco (6.2% vs 15.7%, p<0.001). In multivariable-adjusted analyses, risk of PPC in patients with impaired DLco was more than 2 times [the adjusted odds ratio (aOR)=2.44 (1.58,3.77)] compared to those in patients with preserved DLco. Also, with every 10% decreasing in % pred DLco, the risk of developing PPC was gradually increased. [DLco ≥80 vs. 70≤DLco<80, aOR=2.07 (1.22, 3.49); 60≤DLco<70, aOR=2.79 (1.45, 5.36); DLco<60, aOR=4.69 (1.72, 12.75), p<0.001] Patients with impaired DLco had more risk of PPCs after lung resection even without airflow obstruction. Assessment of DLco is necessary for the prediction of PPCs in lung resection surgery for NSCLC.