Original articleGeneral thoracicDiffusing Capacity Predicts Morbidity After Lung Resection in Patients Without Obstructive Lung Disease
Section snippets
Patients and Methods
We retrospectively reviewed information from our database for all patients undergoing major lung resection (anatomic lobectomy, bilobectomy, pneumonectomy, or completion pneumonectomy) from 1980 through 2006. This protocol was approved by our internal review board, and an exemption was granted for specific patient consent.
Abstracted data included patient demographics; preoperative pulmonary function test results (FEV1 [forced expiratory volume in the first second] expressed as a percent of
Results
During the 1980 to 2006 interval, 1,046 patients underwent major lung resection. Of these, 1,008 had information sufficient to permit assignment to COPD category and form the basis of this study. Patients with COPD were older, had a lower incidence of diabetes mellitus but a higher frequency of prior myocardial infarction, had a higher incidence of unfavorable performance status but less frequently underwent induction therapy, and had substantially worse spirometry and diffusing capacity (Table
Comment
Diffusing capacity of the lung for carbon monoxide was initially investigated in the 1950s and 1960s as a correlate to anatomic changes in the interalveolar septae. Substantially impaired diffusing capacity in patients with emphysema was associated with poor long-term survival [8]. Diffusing capacity subsequently was found to decrease after major lung resection [9, 10, 11, 12], and low Dlco was anecdotally related to an increased risk of operative mortality [13]. In the late 1980s Dlco was
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