Pulmonary arterial enlargement predicts cardiopulmonary complications after pulmonary resection for lung cancer: a retro
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RESEARCH ARTICLE
Open Access
Pulmonary arterial enlargement predicts cardiopulmonary complications after pulmonary resection for lung cancer: a retrospective cohort study Keisuke Asakura1*, Shota Mitsuboshi2, Makoto Tsuji2, Hiroyuki Sakamaki1, Sotaro Otake1, Shinsaku Matsuda1, Kaoru Kaseda2 and Kenichi Watanabe2
Abstract Background: The finding of pulmonary arterial enlargement on computed tomography has been reported to be associated with pulmonary hypertension. On the other hand, pulmonary hypertension is a known risk factor for thoracic surgery. We investigated whether pulmonary arterial enlargement predicts cardiopulmonary complications following pulmonary resection for lung cancer. Methods: We reviewed 237 consecutive patients who underwent pulmonary resection for lung cancer. Preoperative patient characteristics (sex, age, Brinkman index, cardiopulmonary comorbidities, cardiothoracic ratio, pulmonary function, and pulmonary arterial enlargement) and surgical data (surgical procedure, pathological stage, postoperative complications, mortality, and length of postoperative hospital stay) were analyzed. In order to evaluate preoperative pulmonary arterial enlargement, we measured the diameter of the main pulmonary artery at its bifurcation and that of the ascending aorta at its widest point using chest computed tomography and calculated the ratio of the former diameter to the latter. Results: In all, 16 patients developed postoperative cardiopulmonary complications and 221 did not. One patient died from postoperative pneumonia. The mean age of patients who developed postoperative cardiopulmonary complications was significantly higher than that of those who did not (78 ± 5 years vs 69 ± 9 years, P = 0.0001). The pulmonary artery-to-ascending-aorta ratio was significantly higher in patients who developed postoperative complications than in those who did not (0.94 ± 0.15 vs. 0.81 ± 0.11, P = 0.03). Other preoperative patient characteristics and surgical data did not differ significantly between the groups. On multivariate analysis, pulmonary artery-to-ascending-aorta ratio (0.1-point increase; odds ratio 2.3, 95 % confidence interval 1.5–3.5; P = 0.0002) and age (1-year increase; odds ratio 1.2, 95 % confidence interval 1.1–1.3; P = 0.03) were found to be independent predictors of postoperative cardiopulmonary complications. Conclusions: A finding of pulmonary arterial enlargement on computed tomography is a potential predictor of postoperative cardiopulmonary complications after lung cancer surgery. Keywords: Lung cancer, Pulmonary resection, Pulmonary artery, Computed tomography, Pulmonary arterial hypertension
* Correspondence: [email protected] 1 Division of Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan Full list of author information is available at the end of the article © 2015 Asakura et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativec
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