Do Comorbidities Affect Postoperative Complications in Thoracic Surgery Patients Undergoing Lobectomy?
Jeffrey N. Tarascio, Luis E. De Leon, Aaron Dezube, Michael T. Jaklitsch, Carlos Bravo-Iniguez Brigham and Women's Hospital, Boston, MA, USA
Background:
Preoperative evaluation of potential lobectomy patients is a multidisciplinary step to identify risk factors for postoperative morbidity. Surgical candidacy is often placed on pulmonary function tests and comorbidities. The aim of this study is to determine if diabetes, hypertension, and body mass index (BMI) are associated with postoperative complication rates.
Methods:
After obtaining IRB approval, we analyzed all patients who underwent a lobectomy between May 2016 and January 2018. We identified complications through a prospectively collected Morbidity and Mortality Database. The preoperative independent variables used for analysis to compare with post-operative complication rates included age, gender, and the defined comorbidities of COPD, hypertension and BMI. These results were analyzed using X2 and a multivariate logistic regression.
Results:
χ2 testing showed hypertension, BMI, COPD and median age were associated with complication rates [all p<0.05]. The median age for patients without complication and with complications were 65 and 69 respectively [p=0.0013]. After multivariant logistic regression analysis, preoperative hypertension remained statistically associated with postoperative complications with an odds ratio of 1.99 [p=0.009] as did COPD [p<0.001]. However, age [p=0.05] and BMI [p=0.079] were not associated with post-operative complications.
Conclusion:
A statistically significant association existed between age, BMI, hypertension, COPD and postoperative complications. Upon multivariant logistic regression analysis, only COPD and hypertension remained statistically significant. Increased emphasis on management of preoperative metabolic abnormalities may reduce post-operative complication rates.
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