Assessment of pulmonary complications after lung resection

Background. We assessed the utility of maximum oxygen consumption during exercise (MVO2) and diffusing capacity for carbon monoxide (DLCO) in the prediction of postoperative pulmonary complications, and the effect of such complications on postoperative length of hospital stay and the cost of hospitalization. Methods. Candidates for lung resection were prospectively studied by preoperative measurement of DLCO (expressed as a percentage of predicted [DLCO%]) and MVO2. Postoperative pulmonary complications, duration of postoperative hospitalization, and the cost of hospitalization were assessed. Results. Forty patients had lung resection with no operative mortality. The postoperative length of hospitalization was longer for the 13 patients who developed pulmonary complications compared with the 27 patients who did not (7.7 ± 0.8 vs 5.0 ± 0.4 days, respectively; p = 0.007), and the cost of hospitalization in the former group was higher ($11,530 ± $1,959 vs $6,578 ± $406, respectively; p = 0.031). Diffusing capacity was higher in patients without than in patients with pulmonary complications (DLCO% 90.1 ± 5.0 vs 65.3 ± 5.9; p = 0.0034). The mean MVO2 did not differ between the groups (17.8 ± 0.9 vs 16.3 ± 1.2). DLCO% predicted pulmonary complications (p = 0.006). Conclusions. DLCO% predicts the likelihood of pulmonary complications after major lung resection, which are associated with increased length of hospital stay and cost.