Preoperative DLco and FEV₁ are correlated with postoperative pulmonary complications in patients after esophagectomy

Taeyun Kim ^# 1, Yeong Jeong Jeon ^# 2, Hyun Lee ³, Tae Ho Kim ⁴, Seong Yong Park ², Danbee Kang ⁵, Yun Soo Hong ⁶, Genehee Lee ⁷, Junghee Lee ², Sumin Shin ², Jong Ho Cho ², Yong Soo Choi ², Jhingook Kim ², Juhee Cho ^6 7 8, Jae Ill Zo ², Young Mog Shim ², Hong Kwan Kim ^# 9, Hye Yun Park ^# 10

Affiliations Expand

• PMID: 38480929
•  
• PMCID: PMC10937667
•  
• DOI: 10.1038/s41598-024-56593-2

Full text linksCite

Erratum in

• Author Correction: Preoperative DLco and FEV₁ are correlated with postoperative pulmonary complications in patients after esophagectomy.

  Kim T, Jeon YJ, Lee H, Kim TH, Park SY, Kang D, Hong YS, Lee G, Lee J, Shin S, Cho JH, Choi YS, Kim J, Cho J, Zo JI, Shim YM, Kim HK, Park HY.Sci Rep. 2024 Apr 2;14(1):7790. doi: 10.1038/s41598-024-58398-9.PMID: 38565668 Free PMC article. No abstract available.

Abstract

Limited information is available regarding the association between preoperative lung function and postoperative pulmonary complications (PPCs) in patients with esophageal cancer who undergo esophagectomy. This is a retrospective cohort study. Patients were classified into low and high lung function groups by the cutoff of the lowest fifth quintile of forced expiratory volume in 1 s (FEV₁) %predicted (%pred) and diffusing capacity of the carbon monoxide (DLco) %pred. The PPCs compromised of atelectasis requiring bronchoscopic intervention, pneumonia, and acute lung injury/acute respiratory distress syndrome. Modified multivariable-adjusted Poisson regression model using robust error variances and inverse probability treatment weighting (IPTW) were used to assess the relative risk (RR) for the PPCs. A joint effect model considered FEV₁%pred and DLco %pred together for the estimation of RR for the PPCs. Of 810 patients with esophageal cancer who underwent esophagectomy, 159 (19.6%) developed PPCs. The adjusted RR for PPCs in the low FEV₁ group relative to high FEV₁ group was 1.48 (95% confidence interval [CI] = 1.09-2.00) and 1.98 (95% CI = 1.46-2.68) in the low DLco group relative to the high DLco group. A joint effect model showed adjusted RR of PPCs was highest in patients with low DLco and low FEV₁ followed by low DLco and high FEV₁, high DLco and low FEV₁, and high DLco and high FEV₁ (Reference). Results were consistent with the IPTW. Reduced preoperative lung function (FEV₁ and DLco) is associated with post-esophagectomy PPCs. The risk was further strengthened when both values decreased together.

Keywords: DLco; Esophageal cancer; Esophagectomy; FEV1; Pulmonary complications.

© 2024. The Author(s).