Analysis of Risk Factors for Prolonged Air Leak After Lobectomy

Abstract

The aim of the study is to identify risk factors for the development of prolonged air leak in patients after lobectomy and to construct a nomogram to predict such complications.
 Materials and Methods. Between January 2019 and December 31, 2022, 417 lobectomies were performed in patients with non-small cell lung cancer at Regional Clinical Oncological Dispensary in Ulyanovsk. The study included 162 patients who were thoroughly examined. Statistically significant factors influencing the development of prolonged air leak were identified.
 Results. Multivariate logistic regression analysis (results are presented as odds ratio (OR) and 95 % confidence interval) revealed the following parameters: blood loss (1.008; (1.003–1.013)), surgery duration (1.092; (1.029–1.158)), total protein (0.732; (0.598–0.898)), fissura intensity (0.100; (0.015–0.653)), adhesion process (75.505; (6.527–873.056)), and the number of devices (10.233; (1.883–55.590)), independently associated with prolonged air leak. According to this regression, a nomogram was constructed to calculate the probability of prolonged air leak using the model coefficients. The sensitivity and specificity of the developed nomogram for the studied patients were 97.0 % and 93.8 %, respectively.
 Conclusion. The developed prognostic nomogram makes it possible to assess the probability of prolonged air leak development and to prevent it in high-risk patients.