2019 STS: Novel Predictive Tool for Prolonged Air Leak After Lung Cancer Surgery
Posted: Wednesday, February 20, 2019
Investigators have identified factors that increase a patient’s risk of developing a prolonged air leak after lung cancer resection. The team, Christopher W. Seder, MD, of Rush University Medical Center in Chicago and colleagues in New York and Canada, developed a prolonged air leak predictive score with six components. When the total score is more than 20 of a possible 29, the risk of prolonged air leak is 19%; when it is up to 20, the risk is 8%, noted the authors, who presented their findings at the 2019 Society of Thoracic Surgeons (STS) Annual Meeting in San Diego.
Prolonged air leak, defined as a leak lasting for more than 5 days, increases patient discomfort, hospital length of stay, and health-care costs. Utilizing the score, wrote the researchers, may “improve surgical quality by facilitating preoperative counseling, allowing enhanced risk stratification, and developing more effective mitigation strategies.”
The components of the total score are body mass index (≤ 30 kg/m2; 7 points); lobectomy or bilobectomy (7 points); chronic obstructive pulmonary disease (5 points); forced expiratory volume 1 (≤ 60% predicted; 4 points); male gender (3 points); and right upper lung lobe (3 points).
To create the tool, the team utilized data of a sample of 54,838 patients from the STS General Thoracic Surgery Database who met inclusion criteria; the patients had an overall rate of prolonged air leak of 10.4%. The new tool classified patients as being at high risk or low risk for a prolonged air leak with a specificity of 83%, a correct prediction rate of 78%, and a sensitivity of 34%, Dr. Seder and colleagues reported.
Disclosure: The study authors’ disclosure information can be found at sts.org.
