OBJECTIVES: We hypothesized that postoperative cardiorespiratory morbidity and/or 30-day death rates decreased after implementing the new European ERS/ESTS guidelines for functional evaluation before lung resection and tested the hypothesis by means of a case-control study.
METHODS: The analysis included a series of 916 consecutive patients who underwent an anatomical pulmonary resection for non-small-cell lung cancer in our centre. Patients were divided into cases (September 2009-August 2012) and controls (December 2002-August 2009). We reviewed the records from a prospective computerized database; the final dataset included no missing data. The primary studied outcomes were the occurrence of cardiorespiratory morbidity or 30-day death after surgery. The patients were 1: 1 propensity score matched according to the following variables age, ppoFEV1% and the need of pneumonectomy.
RESULTS: After the matching process, 670 cases (335 cases and 335 controls) entered into the study. The rates of pneumonectomy in cases and controls were 5.7 and 13.2%, respectively, (P < 0.0001) in the whole series and 5.7 and 6.9% after matching (P = 0.52). Cardiorespiratory morbidity was 8.1% (27 of 308) in cases and 9.8% (33 of 335) in controls [odds ratio (OR): 0.8; 95% confidence interval (CI): 0.4-1.4]. Thirty-day mortality was 0.90% (3/335) in cases and 1, 2% (4 of 335) in controls (OR: 0.7; 95% CI: 0.1-4.4).
CONCLUSIONS: Although we have observed a trend towards lower cardiorespiratory ...