Hasan ERSÖZ, Sevgi ÖZALEVLİ, Volkan KARAÇAM, Nezih ÖZDEMİR, Ahmet ÖNEN, Ali KARAKILIÇ, Aydın ŞANLI

Role of body mass index, airflow obstruction, dyspnea level, exercise capacity index and maximal oxygen uptake on predicting the postoperative complications of lung resections for patients with lung cancer and chronic obstructive pulmonary disease

Amaç: Bu çalışmada akciğer rezeksiyonu endikasyonu bulunan, kronik obstrüktif akciğer hastalığının eşlik ettiği akciğer kanseri hastalarında vücut kütle indeksi, hava yolu obstrüksiyonu, dispne düzeyi ve egzersiz kapasite (BODE) indeksinin akciğer rezeksiyonlarının ameliyat sonrası komplikasyonlarını öngörmedeki etkisi belirlendi ve bu etki spirometri ve maksimal oksijen alımı ile karşılaştırıldı. Ça lış ma pla nı: Nisan 2012 - Nisan 2013 tarihleri arasında kliniğimizde akciğer rezeksiyonu uygulanan toplam 33 hasta (30 erkek, 3 kadın; ort. yaş 60.4±9.5 yıl; dağılım 32-76 yıl) çalışmaya dahil edildi. Ameliyat öncesinde tüm hastalara spirometri ve merdiven çıkma testi yapıldı, hastaların BODE indeksi ve maksimal oksijen alımı değerleri hesaplandı. Hastalar BODE indekslerine göre dört gruba ayrıldı: Grup 0 (BODE indeksi= 0, n=8), grup 1 (BODE indeksi= 1, n= 14), grup 2 (BODE indeksi= 2, n=7) ve grup 3 (BODE indeksi= 3 ya da 4, n=4).Bul gu lar: Gruplar arasında demografik, klinik özellikler, egzersiz kapasitesi ve ameliyat tipleri açısından anlamlı farklılık yok idi (p>0.05). BODE indeksi spirometrik değerler ile (r= -0.36/-0.58), birçok komplikasyon ile (r=0.49/0.50), entübasyon zamanı ve yoğun bakımda ve hastanede kalış süreleri ile (r=0.34/0.40, p0.05).So nuç: Çalışmamız, spirometrik test ve maksimal oksijen alımı sonuçları ile karşılaştırıldığında BODE indeksinin obstrüktif hava yolu semptomları olan hastaların akciğer rezeksiyonlarında ameliyat sonrası komplikasyonları öngörmede daha üstün olduğunu göstermekte ve klinik uygulamada rutin olarak kullanılması gerektiğini önermektedir.

Akciğer kanseri ve kronik obstrüktif akciğer hastalığı olan hastalarda akciğer rezeksiyonlarının ameliyat sonrası komplikasyonlarını öngörmede vücut kütle indeksi, hava yolu obstrüksiyonu, dispne düzeyi, egzersiz kapasitesi indeksi ile maksimal oksijen alımının rolü

Background: This study aims to investigate the effect of body mass index, airflow obstruction, dyspnea level, and exercise capacity (BODE) index on predicting the postoperative complications of lung resections and compare this effect with spirometry and maximal oxygen uptake in patients with lung cancer accompanied by chronic obstructive pulmonary disease with the indication of lung resection.Methods: A total of 33 patients (30 males, 3 females; mean age 60.4±9.5 years; range 32 to 76 years) who were performed lung resection at our clinic between April 2012 and April 2013 were included in the study. Spirometry and stair climbing test were performed in all patients and their BODE index and maximal oxygen uptake values were calculated preoperatively. The patients were divided into four groups by their BODE index: Group 0 (BODE index= 0, n=8), group 1 (BODE index= 1, n=14), group 2 (BODE index= 2, n=7) and group 3 (BODE index= 3 or 4, n=4).Results: There was no significant difference between the groups in terms of demographics, clinical characteristics, exercise capacity, and operation types (p>0.05). BODE index was significantly correlated with all spirometric values (r= -0.36/-0.58), many complications (r=0.49/0.50), time to intubation, and durations of intensive care unit and hospital stays (r=0.34/0.40, p0.05).Conclusion: Our study indicates that the BODE index is superior in the prediction of postoperative complications of lung resections in patients with obstructive airway symptoms when compared with spirometric test and maximal oxygen uptake results and advises that the BODE index should be routinely used in clinical practice.

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