Pulmonary Respiratory Quotient (PRQ) predicts pulmonary complications after thoracic surgery Meeting Abstract
| Authors: | Barrera, R.; Melendez, J. A. |
| Abstract Title: | Pulmonary Respiratory Quotient (PRQ) predicts pulmonary complications after thoracic surgery |
| Meeting Title: | CHEST 1996 |
| Abstract: | PURPOSE: To develop a new quantitative predictor of post-thoracotomy pulmonary complications using routine lung function tests. METHODS: Data of consecutive patients who underwent lung resection only for malignancy and had preoperative pulmonary function tests; FEV1 and single breath DCO, resting arterial blood gas analysis; P(A-a)O2 and quantitative lung perfusion scans performed in our laboratory were included in this study. Predicted postoperative values (ppo) FEV1%, ppo DCO% and P(A-a)2O were calculated for all patients. Pulmonary complication was defined as pneumonia, atelectasis or respiratory insufficiency requiring therapy. Statistical analysis was performed using Stepwise Logistic Regression (p≤.01) and Relative Risk (odds ratio). RESULTS: Sixty patients were studied, pneumonectomies (n=30) and lobectomies (n=30). The mean age was 65±11 years. Nine patients had pulmonary complications including 2 deaths. The following formula was PRQ=(ppo FEV1%)x(ppo DCO%)2/P(A-a)O2 A PRQ < 3200 was associated with a sensitivity of 100% and specificity of 95% for pulmonary complications. PRQ was associated with a positive predictive value of 75% and a negative predictive value of 100% for pulmonary complications. A PRQ < 3200 was associated with an estimated relative risk of pulmonary complications of 54:1 (95% CL3-972). CONCLUSIONS: The construct PRQ has an excellent association with postoperative pulmonary complications. This novel index not only incorporates predicted postoperative estimates of FEV1% and DCO% but adds P(A-a)O2 and weights the relative contributions of each of the three variables. Pulmonary Respiratory Quotient may be the most significant predictor of pulmonary morbidity in patients undergoing lung resection. CLINICAL IMPLICATIONS: This new index warrants serious prospective evaluation as a predictor of pulmonary morbidity and mortality. |
| Journal Title: | Chest |
| Volume: | 110 |
| Issue: | 4 Suppl. |
| Meeting Dates: | 1996 Oct 27-31 |
| Meeting Location: | San Francisco, CA |
| ISSN: | 0012-3692 |
| Publisher: | American College of Chest Physicians |
| Date Published: | 1996-10-01 |
| Start Page: | 215S |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 8885851 |
| DOI: | 10.1378/chest.110.4_Supplement.210S |
| DOI/URL: | |
| Notes: | Article -- Export Date: 22 November 2017 -- Source: Scopus |
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