PT  - JOURNAL ARTICLE
AU  - Alexey Petrunkin
AU  - Alexey Pichurov
AU  - Oleg Orzheshkovski
AU  - Evgeniy Sokolovich
AU  - Piotr Yablonski
TI  - Lobectomy tolerance in COPD patients
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - 1915
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/1915.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/1915.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Lung cancer is often associated with COPD. COPD patients have higher postoperative risk because of low respiratory reserve. Morbidity and mortality in these patients mounts to 60% and 10-14% respectively (Sekine Y., 2001, Subotich D., 2007).Aim: To investigate factors influencing the risk of postoperative morbidity and mortality and to determine criteria for lobectomy intolerance in COPD patients.Material and methods: 279 patients underwent lobectomy from 2001 to 2008 were included in a retrospective study. Mean age was 61±12, male/female ratio – 204/75. Patients were divided in three groups according to recommendation of GOLD 2007. Group 1 – 154 non-COPD patients, group 2 – 47 patients with mild COPD and group 3 – 78 patients with moderate to severe COPD. Comorbidity of the patients was assessed by using of Charlson comorbidity index (CCI).Results: Morbidity and mortality were found to be increased in patients with more severe obstruction. Thus morbidity was 32% in nonCOPD patients, 34% - with mild COPD and 46% - with moderate to severe one. Mortality was 3.9, 8.5 and 12.8% respectively.However multivariate analysis showed that severity of COPD and predicted postoperative FEV1 were not independent factors of morbidity and mortality.Mortality in patients with ppoFEV1 < 40% was 5%, whereas it was 7% in group with ppoFEV1≥40%.CCI was found to be the only independent risk factor. Morbidity in patients with CCI ≥ 6 was 100%. Combination of CCI ≥ 6 and ppoFEV1 < 50% was accompanied by very high risk of mortality (mounted 70%).Conclusion: ppoFEV1 < 40% is not independent criterion of lobectomy intolerance in COPD patients. Significant factor of functional inoperability is combination of CCI ≥ 6 and ppoFEV1 < 50%.