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Mortality Predictors In Complicated Patients After Anatomical Lung Resection
M A Teresa Gómez Hernández1, Nuria Novoa Valentín1, Marta Fuentes Gago1
1Departamento de Cirugía Torácica. Hospital Universitario de Salamanca, Salamanca, España.
Archivos De Bronconeumologia
|June 5, 2020
Summary
Failure to rescue after lung surgery is a key quality indicator. Pneumonectomy and reoperation significantly increase the risk of mortality following major complications in anatomical lung resections.
Area of Science:
- Thoracic Surgery
- Surgical Quality Improvement
- Patient Outcomes Research
Background:
- Failure to rescue (FTR) quantifies mortality post-complication, reflecting surgical care quality.
- Understanding FTR risk factors after anatomical lung resections is crucial for improving patient outcomes.
Purpose of the Study:
- To identify and analyze risk factors associated with failure to rescue (FTR) in patients undergoing anatomical lung resections.
- To provide data for targeted interventions to reduce mortality after major postoperative complications.
Main Methods:
- Retrospective analysis of 2,569 patients undergoing anatomical lung resection (1994-2018).
- Complications classified using standardized morbidity grading; FTR defined as death after major complication.
- Stepwise logistic regression and ROC curve analysis used to identify FTR predictors.
Main Results:
- 223 patients (8.9%) experienced major complications; 49 (22% of those with major complications) represented FTR.
- Significant FTR predictors included advanced age (OR 1.07), cerebrovascular accident history (OR 3.53), pneumonectomy (OR 6.67), and reintervention (OR 12.26).
- The logistic regression model demonstrated good predictive capacity (AUC 0.82).
Conclusions:
- 22% of patients with major complications after anatomical lung resection did not survive.
- Pneumonectomy and reintervention are identified as the most significant risk factors for failure to rescue.
- These findings highlight critical areas for quality improvement initiatives in thoracic surgery.
Keywords:
Fallo en el rescateMortalidad postoperatoriaPostoperative mortalityPulmonary resectionRescue failureResección pulmonarRiesgo quirúrgicoSurgical risk
