Preoperative DLco and FEV1 are correlated with postoperative pulmonary complications in patients after esophagectomy

Taeyun Kim, Yeong Jeong Jeon, Hyun Lee, Tae Ho Kim, Seong Yong Park, Danbee Kang, Yun Soo Hong, Genehee Lee, Junghee Lee, Sumin Shin, Jong Ho Cho, Yong Soo Choi, Jhingook Kim, Juhee Cho, Jae Ill Zo, Young Mog Shim, Hong Kwan Kim, Hye Yun Park

Research output: Contribution to journalArticlepeer-review

Abstract

Limited information is available regarding the association between preoperative lung function and postoperative pulmonary complications (PPCs) in patients with esophageal cancer who undergo esophagectomy. This is a retrospective cohort study. Patients were classified into low and high lung function groups by the cutoff of the lowest fifth quintile of forced expiratory volume in 1 s (FEV1) %predicted (%pred) and diffusing capacity of the carbon monoxide (DLco) %pred. The PPCs compromised of atelectasis requiring bronchoscopic intervention, pneumonia, and acute lung injury/acute respiratory distress syndrome. Modified multivariable-adjusted Poisson regression model using robust error variances and inverse probability treatment weighting (IPTW) were used to assess the relative risk (RR) for the PPCs. A joint effect model considered FEV1%pred and DLco %pred together for the estimation of RR for the PPCs. Of 810 patients with esophageal cancer who underwent esophagectomy, 159 (19.6%) developed PPCs. The adjusted RR for PPCs in the low FEV1 group relative to high FEV1 group was 1.48 (95% confidence interval [CI] = 1.09–2.00) and 1.98 (95% CI = 1.46–2.68) in the low DLco group relative to the high DLco group. A joint effect model showed adjusted RR of PPCs was highest in patients with low DLco and low FEV1 followed by low DLco and high FEV1, high DLco and low FEV1, and high DLco and high FEV1 (Reference). Results were consistent with the IPTW. Reduced preoperative lung function (FEV1 and DLco) is associated with post-esophagectomy PPCs. The risk was further strengthened when both values decreased together.

Original languageEnglish
Article number6117
JournalScientific Reports
Volume14
Issue number1
DOIs
StatePublished - Mar 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Keywords

  • DLco
  • Esophageal cancer
  • Esophagectomy
  • FEV
  • Pulmonary complications

Fingerprint

Dive into the research topics of 'Preoperative DLco and FEV1 are correlated with postoperative pulmonary complications in patients after esophagectomy'. Together they form a unique fingerprint.

Cite this