Table 1.
Population characteristics of patients with or without prolonged air leak
| Prolonged air leak | |||||
|---|---|---|---|---|---|
| Variables | Total n=2317 |
No n=2117 |
Yes n=200 |
p-value | |
| Demographics | |||||
| Age (mean ± SD) | 65 ± 12 | 65± 12 | 67 ± 11 | 0.013 | |
| BMI, kg/m (mean ± SD) | 28 ± 7 | 28 ± 7 | 26 ± 5 | <0.001 | |
| Sex | Female | 1296 (56) | 1193 (56) | 103 (51) | 0.186 |
| Male | 1021 (44) | 924 (44) | 97 (49) | ||
| Race | White | 2168 (94) | 1975 (93) | 193 (96) | 0.288* |
| Black | 119 (5) | 113 (5) | 6 (3) | ||
| Other | 30 (1) | 29 (1) | 1 (1) | ||
|
| |||||
| Treatment Variables | |||||
| Surgery Year | 2009/10 | 857 (37) | 777 (37) | 80 (40) | 0.615 |
| 2011/12 | 886 (38) | 815 (38) | 71 (35) | ||
| 2013/14 | 574 (25) | 525 (25) | 49 (25) | ||
| Hospital Type | Academic | 1125 (49) | 1030 (49) | 95(48) | 0.755 |
| Community | 1192 (51) | 1087 (51) | 105 (52) | ||
| Annual Surgeon Caseload, median [IQR]a | 53 [34–74] | 53[34–74] | 64 [36–74] | <0.001† | |
| Disease Category | Malignant cancer | 1441 (62) | 1290 (61) | 151 (76) | <0.001 |
| Benign/infection | 367 (16) | 346 (16) | 21 (10) | ||
| Metastatic tumor | 509 (22) | 481 (23) | 28 (14) | ||
| Procedure Type | Lobe/Segment | 1500 (65) | 1339 (63) | 161 (81) | <0.001* |
| Wedge resection | 780 (34) | 752 (36) | 28 (14) | ||
| Bilobectomy | 37 (1) | 26 (1) | 11 (5) | ||
|
| |||||
| Comorbidities | |||||
| Smoking History | Never Smoker | 684 (30) | 655 (31) | 29 (14) | <0.001 |
| Past Smoker | 1180 (50) | 1058 (50) | 122 (61) | ||
| Current Smoker | 453 (20) | 404 (19) | 49 (25) | ||
| Zubrod Score | 0 | 163 (7) | 153 (7) | 10 (5) | 0.012 |
| 1 | 1756 (76) | 1615 (77) | 141 (71) | ||
| 2–5 | 390 (17) | 342 (16) | 48 (24) | ||
| ASA Classification | I/II | 277 (12) | 263 (13) | 14 (7) | 0.077 |
| III | 1781 (77) | 1618 (76) | 163 (82) | ||
| IV | 259 (11) | 236 (11) | 23 (11) | ||
| Weight Loss | ≥2kg | 1985 (86) | 1825 (86) | 160 (80) | 0.527 |
| >2kg | 113 (5) | 102 (5) | 11 (5) | ||
| Missing | 219 (9) | 190 (9) | 29 (15) | ||
| Hypertension | 1297 (56) | 1192 (56) | 105 (53) | 0.300 | |
| Congestive Heart Failure (24% missing) | 76 (4) | 67 (4) | 9 (6) | 0.234 | |
| Peripheral Vascular Disease | 225 (10) | 199 (10) | 26 (13) | 0.101 | |
| Interstitial Fibrosis | 27 (1) | 23 (1) | 4 (2) | 0.286* | |
| Diabetes | 419 (18) | 392 (19) | 27 (14) | 0.077 | |
| COPD | 771 (33) | 672 (32) | 99 (50) | <0.001 | |
| Cerebrovascular Disease | 141 (6) | 127 (6) | 14 (7) | 0.574 | |
| Preoperative Chemotherapy | 470 (20) | 433 (21) | 37 (19) | 0.505 | |
| Preoperative Radiation Therapy | 314 (14) | 282 (13) | 32 (16) | 0.294 | |
| Steroids | 127 (5) | 112 (5) | 15 (8) | 0.190 | |
| Prior Cardiothoracic Surgery | 512 (22) | 455 (22) | 57 (29) | 0.024 | |
| Reoperationb | 289 (13) | 249 (12) | 40 (20) | 0.001 | |
|
| |||||
| Laboratory | |||||
| FEV1, % predicted (12.8% missing; mean ± SD) |
83 ± 22 | 84 ± 21 | 76 ± 24 | <0.001 | |
| FEV1, % predicted | >80 | 1173 (51) | 1089 (52) | 84 (42) | <0.001 |
| <60 | 561 (24) | 496 (23) | 65 (33) | ||
| ≥60 and <80 | 285 (12) | 238 (11) | 47 (23) | ||
| Unmeasured | 297 (13) | 293 (14) | 4 (2) | ||
| DLCO, % predicted (28% missing; mean ± SD) |
71 ± 23 | 72 ± 23 | 66 ± 24 | 0.002 | |
| Last Hemoglobin (mean ± SD) | 12.1±1.7 | 12.2±1.7 | 12.0±1.7 | 0.152 | |
| Last Creatinine, median [IQR] | 0.85 [0.7–1] | 0.87 [0.7–1] | 0.80 [0.7–1] | 0.628† | |
|
| |||||
| Operative Details | |||||
| Status | Elective | 2214 (96) | 2018 (96) | 196 (98) | 0.145 |
| Urgent/Emergent | 90 (4) | 86 (4) | 4 (2) | ||
| Preoperative | <1 day | 2157 (93) | 1963 (93) | 194 (97) | 0.025 |
| Hospitalization | ≥1 day | 158 (7) | 152 (7) | 6 (3) | |
| Laterality | Left | 915 (40) | 854 (40) | 61 (30) | 0.004 |
| Right | 1377 (59) | 1238 (59) | 139 (70) | ||
| Missing | 25 (1) | 25 (1) | 0 (0) | ||
| Robot-Assisted Surgery | 82 (3) | 79 (4) | 3 (2) | 0.102 | |
| Surgical Approach | Thoracotomy | 603 (26) | 515 (24) | 88 (44) | <0.001 |
| VATS | 1714 (74) | 1602 (76) | 112 (56) | ||
| OR Blood Transfusion | 94 (4) | 84 (4) | 10 (5) | 0.487 | |
|
| |||||
| Outcomes | |||||
| Hospital Stay, median [IQR] | 4 [3–7] | 4 [3–6] | 10 [8–14] | <0.001† | |
| Hospital Death | 29 (1) | 23 (1) | 6 (3) | 0.034* | |
Values n (%), and <1% missing unless indicated otherwise.
a
average annual cases by patient’s operating surgeon in study time period
b
cardiac or thoracic re-operation that affects operative field
*
Fisher’s exact
†
Wilcoxon rank sum test
BMI, body mass index,%FEV1, percentage of predicted value of forced expiratory volume in 1 second; DLCO, diffusing capacity of carbon monoxide; ASA, American Association of Anesthesiology; COPD, chronic obstructive pulmonary disease; VATS, video-assisted thoracoscopic surgery; SD, standard deviation; OR, operating room; IQR, interquartile range