S-Space College of Medicine/School of Medicine (의과대학/대학원) Thoracic Surgery (흉부외과학전공) Journal Papers (저널논문_흉부외과학전공)
Postoperative air leak grading is useful to predict prolonged air leak after pulmonary lobectomy
- Oh, Sang Gi; Jung, Yochun; Jheon, Sanghoon; Choi, Yunhee; Yun, Ju Sik; Na, Kook Joo; Ahn, Byoung Hee
- Issue Date
- BioMed Central
- Journal of Cardiothoracic Surgery, 12(1):1
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Results of studies to predict prolonged air leak (PAL; air leak longer than 5 days) after pulmonary lobectomy have been inconsistent and are of limited use. We developed a new scale representing the amount of early postoperative air leak and determined its correlation with air leak duration and its potential as a predictor of PAL.
We grade postoperative air leak using a 5-grade scale. All 779 lobectomies from January 2005 to December 2009 with available medical records were reviewed retrospectively. We devised six SUM variables using air leak grades in the initial 72 h postoperatively.
Excluding unrecorded cases and postoperative broncho-pleural fistulas, there were 720 lobectomies. PAL occurred in 135 cases (18.8%). Correlation analyses showed each SUM variable highly correlated with air leak duration, and the SUM4to9, which was the sum of six consecutive values of air leak grades for every 8 h record on postoperative days 2 and 3, was proved to be the most powerful predictor of PAL; PAL could be predicted with 75.7% and 77.7% positive and negative predictive value, respectively, when SUM4to9 ≥ 16. When 4 predictors derived from multivariable logistic regression of perioperative variables were combined with SUM4to9, there was no significant increase in predictability compared with SUM4to9 alone.
This simple new method to predict PAL using SUM4to9 showed that the amount of early postoperative air leak is the most powerful predictor of PAL, therefore, grading air leak after pulmonary lobectomy is a useful method to predict PAL.