Abstract
ObjectivesCough impairment may lead to excessive accumulation of pulmonary secretions and increase the risk of postoperative pulmonary complications (PPCs). Peak expiratory flow (PEF) is a sensitive indicator of cough ability. We aimed to investigate the correlation between PEF and PPCs for lung cancer patients undergoing lobectomy or segmental resection for improved risk assessment.MethodsThis retrospective study assessed 560 patients with non-small cell lung cancer admitted for surgery between January 2014 to June 2016. The measurements of PEF were performed before surgery and the clinical outcomes were recorded, including PPCs, postoperative hospital stay, hospitalization costs, and other variables.ResultsPreoperative PEF was significantly lower in PPCs group compared to non-PPCs group (294.2 ± 95.7 vs. 363.0 ± 105.6 L/min, P < 0.001). Multivariable regression analysis showed that high PEF (OR=0.991, 95%CI: 0.988-0.993, P < 0.001) was an independent protective factor for PPCs. According to the receiver operating characteristic (ROC) curve, a PEF value of 250 L/min was selected as the optimal cutoff value in female patients, and 320 L/min in male patients. Patients with PEF under cutoff value of either sex had higher PPCs rate and unfavorable clinical outcomes.ConclusionsPreoperative PEF was found to be a significant predictor of PPCs for surgical lung cancer patients. It may be beneficial to consider the cutoff value of PEF in perioperative risk assessment.
Highlights
Lung cancer continues to be the leading cause of cancer death worldwide and poses to be a threat to human health and economic burden [1]
We hypothesized that preoperative Peak expiratory flow (PEF) would be an effective indicator to predict pulmonary complications (PPCs) that may arise in surgical lung cancer patients
A total of 560 patients who met eligibility criteria were invited to participate in this study, with 104 patients occurred PPCs in 30 days after the operation, who were divided into PPCs group
Summary
Lung cancer continues to be the leading cause of cancer death worldwide and poses to be a threat to human health and economic burden [1]. Several clinical studies have defined risk factors for PPC and consensus risk factors including advanced age, poor lung function status, smoking history, chronic obstructive pulmonary disease (COPD), American Society of Anesthesiologists (ASA) score ≥ 3, and long duration of surgery [5,6,7]. Complications such as postoperative pneumonia, atelectasis and pleural effusion resulting in PPC are mostly caused by the reduced efficiency of cough. We hypothesized that preoperative PEF would be an effective indicator to predict PPCs that may arise in surgical lung cancer patients
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