000			03480nam a22003617a 4500
008			220926s20222022 xxu||||| |||| 00| 0 eng d
022			_a0171-6425
024			_a10.1055/s-0042-1748025 [doi]
040			_aOvid MEDLINE(R)
099			_a35785811
245			_aPredictors of 30-Day Pulmonary Complications after Video-Assisted Thoracoscopic Surgery Lobectomy.
251			_aThoracic & Cardiovascular Surgeon. 2022 Jul 04
252			_aThorac Cardiovasc Surg. 2022 Jul 04
253			_aThe Thoracic and cardiovascular surgeon
260			_c2022
260			_fFY2023
260			_p2022 Jul 04
265			_saheadofprint
266			_d2022-09-26
520			_aBACKGROUND: Pulmonary complications are the most common adverse event after lung resection, yet few large-scale studies have examined pertinent risk factors after video-assisted thoracoscopic surgery (VATS) lobectomy. Veterans, older and less healthy compared with nonveterans, represent a cohort that requires further investigation. Our objective is to determine predictors of pulmonary complications after VATS lobectomy in veterans.
520			_aCONCLUSION: This analysis revealed several preoperative factors associated with development of pulmonary complications. It is imperative to optimize pulmonary-specific comorbidities such as COPD or dyspnea prior to VATS lobectomy. However, unhealthy alcohol consumption and hyponatremia were linked with development of pulmonary complication in our analysis and should be addressed prior to VATS lobectomy. Future studies should explore long-term consequences of pulmonary complications. Copyright Thieme. All rights reserved.
520			_aMETHODS: A retrospective review was conducted on patients who underwent VATS lobectomy from 2008 to 2018 using the Veterans Affairs Surgical Quality Improvement Program database. Patients were divided into two cohorts based on development of a pulmonary complication within 30 days. Patient characteristics were compared via multivariable analysis to determine clinical predictors associated with pulmonary complication and reported as adjusted odds ratios (aORs) with 95% confidence intervals. Patients with preoperative pneumonia, ventilator dependence, and emergent cases were excluded.
520			_aRESULTS: In 4,216 VATS lobectomy cases, 480 (11.3%) cases had >=1 pulmonary complication. Preoperative factors independently associated with pulmonary complication included chronic obstructive pulmonary disease (COPD) (aOR = 1.37 [1.12-1.69]; p = 0.003), hyponatremia (aOR = 1.50 [1.06-2.11]; p = 0.021), and dyspnea (aOR = 1.33 [1.06-1.66]; p = 0.013). Unhealthy alcohol consumption was associated with pulmonary complication via univariable analysis (17.1 vs. 13.0%; p = 0.016). Cases with pulmonary complication were associated with increased mortality (12.1 vs. 0.8%; p < 0.001) and longer length of stay (12.0 vs. 6.8 days; p < 0.001).
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
656			_aMedStar General Surgery Residency
657			_aJournal Article
700			_aHolleran, Timothy _bMGUH _cMedStar General Surgery Residency _dMD _eResident PGY 4
790			_aAmdur RL, Antevil JL, Duggan JP, Holleran TJ, Napolitano MA, Peters AS, Trachiotis GD
856			_uhttps://dx.doi.org/10.1055/s-0042-1748025 _zhttps://dx.doi.org/10.1055/s-0042-1748025
942			_cART _dArticle
999			_c407 _d407