Factors related to outcome after pneumonectomy : Retrospective study of 62 patients

Objective: To find out which risk factors affect outcome after pneumonectomy.Design: Retrospective study.Setting: Teaching hospital, The Netherlands.Subjects: 62 patients who were treated for bronchial cancer by pneumonectomy between 1984 and 1995.Main outcome measure: Hospital mortality and postoperative complications.Results: Hospital mortality increased with age, being 5/51 (10%) in the 40-69 age group and 4/11 (36%) in patients aged 70 or more. In the American Society of Anesthesiologists (ASA) class I group hospital mortality was 8% (2/26), in class II 12% (3/26) and in class III 40% (4/10). Hospital mortality was highest when the FEV1:FVC-ratio was below 55%. Cardiac arrhythmias developed in 8 (13%), early bronchopleural fistulas in 7 (11%), and postpneumonectomy syndrome in 5 (8%). These major complications had a high mortality.Conclusion: Respiratory function, ASA class, and age over 70 years are the main prognostic factors for hospital morbidity and mortality after pneumonectomy.