Perioperative factors as predictors of operative mortality and morbidity in pneumonectomy

Pneumonectomy for lung cancer is associated with significant morbidity and mortality. Risk factors for the morbidity and mortality have been reported, but consistent conclusive data are undetermined. Current accepted 30-day m ortality rates for pneumonectomy range from 7 to 11 per cent. The objective of this study is to determine whether various perioperative factors can se rve as predictors of morbidity and mortality in pneumonectomy patients and to review outcome data on patients undergoing pneumonectomy for lung cancer . A total of 105 patients undergoing pneumonectomy for lung cancer from 198 8 through 1998 are studied in a retrospective chart review. The main outcom e measure is the 30-day operative mortality and morbidity, Complications oc curring in 10 per cent or more of the patients included atrial fibrillation (33.3%), respiratory failure (23.8%), pneumonia (21.9%), and bronchopleura l fistula (12.4%). The 30-day mortality rate was 10.5 per cent (11 deaths). By Fisher's exact test for Chi-square only three statistically significant mortality factors were identified: respiratory failure (P < 0.021), sepsis (P < 0.008), and male sex (P < 0.031); respiratory failure, sepsis, and se x were predictors of death. Significant correlation could not be made to pr edict postoperative morbidity, Overall long-term clinical outcome for pneum onectomy as lung cancer treatment was poor. Clinical judgment remains an es sential factor when considering pneumonectomy as an option for lung cancer treatment.