The influence of nutritional status on complications after operations for lung cancer

Background. Nutritional status is known to play an important role in determ ining outcome after many types of operations but its importance relative to nonnutritional indices in patients undergoing an operation for lung cancer is unclear. Methods. Detailed nutritional and nonnutritional assessment of 52 patients undergoing surgical resection of lung cancer was performed. The frequency o f postoperative complications and length of intercostal drainage time were recorded, and the relation between preoperative indices and postoperative o utcome was assessed. Results. Patients who died or needed reventilation had poorer nutritional s tatus, worse lung function, and lower maximum expiratory pressures than tho se who did not. Using multiple logistic regression, the best model (R-2 = 0 .39) to predict death combined operation type, preoperative carbon monoxide transfer factor (% predicted), and maximum expiratory pressure (% predicte d). Operation type and the fat-free mass index (FFMI) alone were only sligh tly less informative (R-2 = 0.35). Far reventilation the best model (R-2 = 0.80) combined operation type, body mass index (BMI), and maximum expirator y pressure (% predicted). Intercostal drainage time after lobectomy was sig nificantly related only to preoperative lymphocyte count (p = 0.004) and su bjective global assessment score (p = 0.02). Conclusions. Impaired nutrition is an important predictor of death and the need for reventilation after an operation for lung cancer, and the selectio n of patients for lung resection might be improved by measuring simple nutr itional indices such as BMI and the FFMI. (C) 2001 by The Society of Thorac ic Surgeons.