Pulmonary arterial enlargement predicts cardiopulmonary complications after pulmonary resection for lung cancer: A retrospective cohort study

Keisuke Asakura, Shota Mitsuboshi, Makoto Tsuji, Hiroyuki Sakamaki, Sotaro Otake, Shinsaku Matsuda, Kaoru Kaseda, Kenichi Watanabe

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The finding of pulmonary arterial enlargement on computed tomography has been reported to be associated with pulmonary hypertension. On the other hand, pulmonary hypertension is a known risk factor for thoracic surgery. We investigated whether pulmonary arterial enlargement predicts cardiopulmonary complications following pulmonary resection for lung cancer. Methods: We reviewed 237 consecutive patients who underwent pulmonary resection for lung cancer. Preoperative patient characteristics (sex, age, Brinkman index, cardiopulmonary comorbidities, cardiothoracic ratio, pulmonary function, and pulmonary arterial enlargement) and surgical data (surgical procedure, pathological stage, postoperative complications, mortality, and length of postoperative hospital stay) were analyzed. In order to evaluate preoperative pulmonary arterial enlargement, we measured the diameter of the main pulmonary artery at its bifurcation and that of the ascending aorta at its widest point using chest computed tomography and calculated the ratio of the former diameter to the latter. Results: In all, 16 patients developed postoperative cardiopulmonary complications and 221 did not. One patient died from postoperative pneumonia. The mean age of patients who developed postoperative cardiopulmonary complications was significantly higher than that of those who did not (78 ± 5years vs 69 ± 9years, P = 0.0001). The pulmonary artery-to-ascending-aorta ratio was significantly higher in patients who developed postoperative complications than in those who did not (0.94 ± 0.15 vs. 0.81 ± 0.11, P = 0.03). Other preoperative patient characteristics and surgical data did not differ significantly between the groups. On multivariate analysis, pulmonary artery-to-ascending-aorta ratio (0.1-point increase; odds ratio 2.3, 95% confidence interval 1.5-3.5; P = 0.0002) and age (1-year increase; odds ratio 1.2, 95% confidence interval 1.1-1.3; P = 0.03) were found to be independent predictors of postoperative cardiopulmonary complications. Conclusions: A finding of pulmonary arterial enlargement on computed tomography is a potential predictor of postoperative cardiopulmonary complications after lung cancer surgery.

Original languageEnglish
Article number113
JournalJournal of Cardiothoracic Surgery
Volume10
Issue number1
DOIs
Publication statusPublished - 2015 Sep 9

Fingerprint

Lung Neoplasms
Cohort Studies
Retrospective Studies
Lung
Pulmonary Artery
Aorta
Tomography
Pulmonary Hypertension
Odds Ratio
Confidence Intervals
Sex Characteristics
Thoracic Surgery
Comorbidity
Length of Stay
Pneumonia
Thorax
Multivariate Analysis
Mortality

Keywords

  • Computed tomography
  • Lung cancer
  • Pulmonary arterial hypertension
  • Pulmonary artery
  • Pulmonary resection

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Pulmonary arterial enlargement predicts cardiopulmonary complications after pulmonary resection for lung cancer : A retrospective cohort study. / Asakura, Keisuke; Mitsuboshi, Shota; Tsuji, Makoto; Sakamaki, Hiroyuki; Otake, Sotaro; Matsuda, Shinsaku; Kaseda, Kaoru; Watanabe, Kenichi.

In: Journal of Cardiothoracic Surgery, Vol. 10, No. 1, 113, 09.09.2015.

Research output: Contribution to journalArticle

Asakura, Keisuke ; Mitsuboshi, Shota ; Tsuji, Makoto ; Sakamaki, Hiroyuki ; Otake, Sotaro ; Matsuda, Shinsaku ; Kaseda, Kaoru ; Watanabe, Kenichi. / Pulmonary arterial enlargement predicts cardiopulmonary complications after pulmonary resection for lung cancer : A retrospective cohort study. In: Journal of Cardiothoracic Surgery. 2015 ; Vol. 10, No. 1.
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abstract = "Background: The finding of pulmonary arterial enlargement on computed tomography has been reported to be associated with pulmonary hypertension. On the other hand, pulmonary hypertension is a known risk factor for thoracic surgery. We investigated whether pulmonary arterial enlargement predicts cardiopulmonary complications following pulmonary resection for lung cancer. Methods: We reviewed 237 consecutive patients who underwent pulmonary resection for lung cancer. Preoperative patient characteristics (sex, age, Brinkman index, cardiopulmonary comorbidities, cardiothoracic ratio, pulmonary function, and pulmonary arterial enlargement) and surgical data (surgical procedure, pathological stage, postoperative complications, mortality, and length of postoperative hospital stay) were analyzed. In order to evaluate preoperative pulmonary arterial enlargement, we measured the diameter of the main pulmonary artery at its bifurcation and that of the ascending aorta at its widest point using chest computed tomography and calculated the ratio of the former diameter to the latter. Results: In all, 16 patients developed postoperative cardiopulmonary complications and 221 did not. One patient died from postoperative pneumonia. The mean age of patients who developed postoperative cardiopulmonary complications was significantly higher than that of those who did not (78 ± 5years vs 69 ± 9years, P = 0.0001). The pulmonary artery-to-ascending-aorta ratio was significantly higher in patients who developed postoperative complications than in those who did not (0.94 ± 0.15 vs. 0.81 ± 0.11, P = 0.03). Other preoperative patient characteristics and surgical data did not differ significantly between the groups. On multivariate analysis, pulmonary artery-to-ascending-aorta ratio (0.1-point increase; odds ratio 2.3, 95{\%} confidence interval 1.5-3.5; P = 0.0002) and age (1-year increase; odds ratio 1.2, 95{\%} confidence interval 1.1-1.3; P = 0.03) were found to be independent predictors of postoperative cardiopulmonary complications. Conclusions: A finding of pulmonary arterial enlargement on computed tomography is a potential predictor of postoperative cardiopulmonary complications after lung cancer surgery.",
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AU - Mitsuboshi, Shota

AU - Tsuji, Makoto

AU - Sakamaki, Hiroyuki

AU - Otake, Sotaro

AU - Matsuda, Shinsaku

AU - Kaseda, Kaoru

AU - Watanabe, Kenichi

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N2 - Background: The finding of pulmonary arterial enlargement on computed tomography has been reported to be associated with pulmonary hypertension. On the other hand, pulmonary hypertension is a known risk factor for thoracic surgery. We investigated whether pulmonary arterial enlargement predicts cardiopulmonary complications following pulmonary resection for lung cancer. Methods: We reviewed 237 consecutive patients who underwent pulmonary resection for lung cancer. Preoperative patient characteristics (sex, age, Brinkman index, cardiopulmonary comorbidities, cardiothoracic ratio, pulmonary function, and pulmonary arterial enlargement) and surgical data (surgical procedure, pathological stage, postoperative complications, mortality, and length of postoperative hospital stay) were analyzed. In order to evaluate preoperative pulmonary arterial enlargement, we measured the diameter of the main pulmonary artery at its bifurcation and that of the ascending aorta at its widest point using chest computed tomography and calculated the ratio of the former diameter to the latter. Results: In all, 16 patients developed postoperative cardiopulmonary complications and 221 did not. One patient died from postoperative pneumonia. The mean age of patients who developed postoperative cardiopulmonary complications was significantly higher than that of those who did not (78 ± 5years vs 69 ± 9years, P = 0.0001). The pulmonary artery-to-ascending-aorta ratio was significantly higher in patients who developed postoperative complications than in those who did not (0.94 ± 0.15 vs. 0.81 ± 0.11, P = 0.03). Other preoperative patient characteristics and surgical data did not differ significantly between the groups. On multivariate analysis, pulmonary artery-to-ascending-aorta ratio (0.1-point increase; odds ratio 2.3, 95% confidence interval 1.5-3.5; P = 0.0002) and age (1-year increase; odds ratio 1.2, 95% confidence interval 1.1-1.3; P = 0.03) were found to be independent predictors of postoperative cardiopulmonary complications. Conclusions: A finding of pulmonary arterial enlargement on computed tomography is a potential predictor of postoperative cardiopulmonary complications after lung cancer surgery.

AB - Background: The finding of pulmonary arterial enlargement on computed tomography has been reported to be associated with pulmonary hypertension. On the other hand, pulmonary hypertension is a known risk factor for thoracic surgery. We investigated whether pulmonary arterial enlargement predicts cardiopulmonary complications following pulmonary resection for lung cancer. Methods: We reviewed 237 consecutive patients who underwent pulmonary resection for lung cancer. Preoperative patient characteristics (sex, age, Brinkman index, cardiopulmonary comorbidities, cardiothoracic ratio, pulmonary function, and pulmonary arterial enlargement) and surgical data (surgical procedure, pathological stage, postoperative complications, mortality, and length of postoperative hospital stay) were analyzed. In order to evaluate preoperative pulmonary arterial enlargement, we measured the diameter of the main pulmonary artery at its bifurcation and that of the ascending aorta at its widest point using chest computed tomography and calculated the ratio of the former diameter to the latter. Results: In all, 16 patients developed postoperative cardiopulmonary complications and 221 did not. One patient died from postoperative pneumonia. The mean age of patients who developed postoperative cardiopulmonary complications was significantly higher than that of those who did not (78 ± 5years vs 69 ± 9years, P = 0.0001). The pulmonary artery-to-ascending-aorta ratio was significantly higher in patients who developed postoperative complications than in those who did not (0.94 ± 0.15 vs. 0.81 ± 0.11, P = 0.03). Other preoperative patient characteristics and surgical data did not differ significantly between the groups. On multivariate analysis, pulmonary artery-to-ascending-aorta ratio (0.1-point increase; odds ratio 2.3, 95% confidence interval 1.5-3.5; P = 0.0002) and age (1-year increase; odds ratio 1.2, 95% confidence interval 1.1-1.3; P = 0.03) were found to be independent predictors of postoperative cardiopulmonary complications. Conclusions: A finding of pulmonary arterial enlargement on computed tomography is a potential predictor of postoperative cardiopulmonary complications after lung cancer surgery.

KW - Computed tomography

KW - Lung cancer

KW - Pulmonary arterial hypertension

KW - Pulmonary artery

KW - Pulmonary resection

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