Qualitative analysis of preoperative high-resolution computed tomography: Risk factors for pulmonary complications after major lung resection

Yusuke Takahashi, Megumi Matsuda, Shuri Aoki, Hitoshi Dejima, Takashi Nakayama, Noriyuki Matsutani, Masafumi Kawamura

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background Postoperative pulmonary complications after major lung resection are strongly associated with mortality. Qualitative findings of emphysema, bronchiectasis, and bronchial wall thickening on high-resolution computed tomography (HRCT) are indicators of chronic obstructive pulmonary disease and may serve as risk factors for pulmonary complications. Methods The subjects were 347 consecutive patients who underwent single lobectomy for pulmonary malignancy from May 2010 to December 2014. Correlations of pulmonary complications with preoperative clinical factors and HRCT findings were retrospectively examined using multivariate logistic regression analysis to compare the predictive ability for pulmonary complications using clinical variables that were reported to be risk factors. Results Patients who had pulmonary complications were more frequently male (p < 0.001), with a greater smoking history (p < 0.001), lower rate of steroid use (p < 0.001), more frequent emphysema on HRCT (p < 0.001), more frequent bronchiectasis on HRCT (p = 0.002), more frequent bronchial wall thickening on HRCT (p < 0.001), and higher rate of extended resection (p = 0.006). In multivariate analysis, HRCT findings (odds ratio [OR] 12.01, 95% confidence interval [CI]: 5.582 to 25.83, p < 0.001) and extended resection (OR 7.726, 95% CI: 1.678 to 35.57, p = 0.009) were independent risk factors for pulmonary complications. After matching of risk factors between patients with and without pulmonary complication, emphysema (OR 3.394, 95% CI: 1.781 to 6.469, p < 0.001) and bronchial wall thickening (OR 6.250, 95% CI: 2.414 to 16.18, p < 0.001) were independently associated with pulmonary complications in the model with better performance. Conclusions Qualitative findings on HRCT are independent risk factors for pulmonary complications after lobectomy. Preoperative HRCT may be useful to predict pulmonary complications.

Original languageEnglish
Pages (from-to)1068-1074
Number of pages7
JournalAnnals of Thoracic Surgery
Volume101
Issue number3
DOIs
Publication statusPublished - 2016 Mar 1
Externally publishedYes

Fingerprint

Tomography
Lung
Odds Ratio
Confidence Intervals
Bronchiectasis
Emphysema
Pulmonary Emphysema
Aptitude
Chronic Obstructive Pulmonary Disease
Multivariate Analysis
Logistic Models
Smoking
History
Steroids
Regression Analysis
Mortality
Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Qualitative analysis of preoperative high-resolution computed tomography : Risk factors for pulmonary complications after major lung resection. / Takahashi, Yusuke; Matsuda, Megumi; Aoki, Shuri; Dejima, Hitoshi; Nakayama, Takashi; Matsutani, Noriyuki; Kawamura, Masafumi.

In: Annals of Thoracic Surgery, Vol. 101, No. 3, 01.03.2016, p. 1068-1074.

Research output: Contribution to journalArticle

Takahashi, Yusuke ; Matsuda, Megumi ; Aoki, Shuri ; Dejima, Hitoshi ; Nakayama, Takashi ; Matsutani, Noriyuki ; Kawamura, Masafumi. / Qualitative analysis of preoperative high-resolution computed tomography : Risk factors for pulmonary complications after major lung resection. In: Annals of Thoracic Surgery. 2016 ; Vol. 101, No. 3. pp. 1068-1074.
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abstract = "Background Postoperative pulmonary complications after major lung resection are strongly associated with mortality. Qualitative findings of emphysema, bronchiectasis, and bronchial wall thickening on high-resolution computed tomography (HRCT) are indicators of chronic obstructive pulmonary disease and may serve as risk factors for pulmonary complications. Methods The subjects were 347 consecutive patients who underwent single lobectomy for pulmonary malignancy from May 2010 to December 2014. Correlations of pulmonary complications with preoperative clinical factors and HRCT findings were retrospectively examined using multivariate logistic regression analysis to compare the predictive ability for pulmonary complications using clinical variables that were reported to be risk factors. Results Patients who had pulmonary complications were more frequently male (p < 0.001), with a greater smoking history (p < 0.001), lower rate of steroid use (p < 0.001), more frequent emphysema on HRCT (p < 0.001), more frequent bronchiectasis on HRCT (p = 0.002), more frequent bronchial wall thickening on HRCT (p < 0.001), and higher rate of extended resection (p = 0.006). In multivariate analysis, HRCT findings (odds ratio [OR] 12.01, 95{\%} confidence interval [CI]: 5.582 to 25.83, p < 0.001) and extended resection (OR 7.726, 95{\%} CI: 1.678 to 35.57, p = 0.009) were independent risk factors for pulmonary complications. After matching of risk factors between patients with and without pulmonary complication, emphysema (OR 3.394, 95{\%} CI: 1.781 to 6.469, p < 0.001) and bronchial wall thickening (OR 6.250, 95{\%} CI: 2.414 to 16.18, p < 0.001) were independently associated with pulmonary complications in the model with better performance. Conclusions Qualitative findings on HRCT are independent risk factors for pulmonary complications after lobectomy. Preoperative HRCT may be useful to predict pulmonary complications.",
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T2 - Risk factors for pulmonary complications after major lung resection

AU - Takahashi, Yusuke

AU - Matsuda, Megumi

AU - Aoki, Shuri

AU - Dejima, Hitoshi

AU - Nakayama, Takashi

AU - Matsutani, Noriyuki

AU - Kawamura, Masafumi

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N2 - Background Postoperative pulmonary complications after major lung resection are strongly associated with mortality. Qualitative findings of emphysema, bronchiectasis, and bronchial wall thickening on high-resolution computed tomography (HRCT) are indicators of chronic obstructive pulmonary disease and may serve as risk factors for pulmonary complications. Methods The subjects were 347 consecutive patients who underwent single lobectomy for pulmonary malignancy from May 2010 to December 2014. Correlations of pulmonary complications with preoperative clinical factors and HRCT findings were retrospectively examined using multivariate logistic regression analysis to compare the predictive ability for pulmonary complications using clinical variables that were reported to be risk factors. Results Patients who had pulmonary complications were more frequently male (p < 0.001), with a greater smoking history (p < 0.001), lower rate of steroid use (p < 0.001), more frequent emphysema on HRCT (p < 0.001), more frequent bronchiectasis on HRCT (p = 0.002), more frequent bronchial wall thickening on HRCT (p < 0.001), and higher rate of extended resection (p = 0.006). In multivariate analysis, HRCT findings (odds ratio [OR] 12.01, 95% confidence interval [CI]: 5.582 to 25.83, p < 0.001) and extended resection (OR 7.726, 95% CI: 1.678 to 35.57, p = 0.009) were independent risk factors for pulmonary complications. After matching of risk factors between patients with and without pulmonary complication, emphysema (OR 3.394, 95% CI: 1.781 to 6.469, p < 0.001) and bronchial wall thickening (OR 6.250, 95% CI: 2.414 to 16.18, p < 0.001) were independently associated with pulmonary complications in the model with better performance. Conclusions Qualitative findings on HRCT are independent risk factors for pulmonary complications after lobectomy. Preoperative HRCT may be useful to predict pulmonary complications.

AB - Background Postoperative pulmonary complications after major lung resection are strongly associated with mortality. Qualitative findings of emphysema, bronchiectasis, and bronchial wall thickening on high-resolution computed tomography (HRCT) are indicators of chronic obstructive pulmonary disease and may serve as risk factors for pulmonary complications. Methods The subjects were 347 consecutive patients who underwent single lobectomy for pulmonary malignancy from May 2010 to December 2014. Correlations of pulmonary complications with preoperative clinical factors and HRCT findings were retrospectively examined using multivariate logistic regression analysis to compare the predictive ability for pulmonary complications using clinical variables that were reported to be risk factors. Results Patients who had pulmonary complications were more frequently male (p < 0.001), with a greater smoking history (p < 0.001), lower rate of steroid use (p < 0.001), more frequent emphysema on HRCT (p < 0.001), more frequent bronchiectasis on HRCT (p = 0.002), more frequent bronchial wall thickening on HRCT (p < 0.001), and higher rate of extended resection (p = 0.006). In multivariate analysis, HRCT findings (odds ratio [OR] 12.01, 95% confidence interval [CI]: 5.582 to 25.83, p < 0.001) and extended resection (OR 7.726, 95% CI: 1.678 to 35.57, p = 0.009) were independent risk factors for pulmonary complications. After matching of risk factors between patients with and without pulmonary complication, emphysema (OR 3.394, 95% CI: 1.781 to 6.469, p < 0.001) and bronchial wall thickening (OR 6.250, 95% CI: 2.414 to 16.18, p < 0.001) were independently associated with pulmonary complications in the model with better performance. Conclusions Qualitative findings on HRCT are independent risk factors for pulmonary complications after lobectomy. Preoperative HRCT may be useful to predict pulmonary complications.

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