Assessment of pulmonary complications after lung resection

Background. We assessed the utility of maximum oxygen consumption during ex ercise (MVO2) and diffusing capacity for carbon monoxide (DLCO) in the pred iction of postoperative pulmonary complications, and the effect of such com plications on postoperative length of hospital stay and the cost of hospita lization. Methods. Candidates for lung resection were prospectively studied by preope rative measurement of DLCO (expressed as a percentage of predicted [DLCO%]) and MVO2. Postoperative pulmonary complications, duration of postoperative hospitalization, and the cost of hospitalization were assessed. Results. Forty patients had lung resection with no operative mortality. The postoperative length of hospitalization was longer for the 13 patients who developed pulmonary complications compared with the 27 patients who did no t (7.7 +/- 0.8 vs 5.0 +/- 0.4 days, respectively; p = 0.007), and the cost of hospitalization in the former group was higher ($11,530 +/- $1,959 vs $6 ,578 +/- $406, respectively; p = 0.031). Diffusing capacity was higher in p atients without than in patients with pulmonary complications (DLCO% 90.1 /- 5.0 vs 65.3 +/- 5.9; p = 0.0034). The mean MVO2 did not differ between t he groups (17.8 +/- 0.9 vs 16.3 +/- 1.2). DLCO% predicted pulmonary complic ations (p = 0.006). Conclusions. DLCO% predicts the likelihood of pulmonary complications after major lung resection, which are associated with increased length of hospit al stay and cost. (Ann Thorac Surg 1499;67:1444-7) (C) 1999 by The Society of Thoracic Surgeons.