CT-based emphysema score is associated with prolonged air leak after lung resection: a retrospective cohort study.
코호트
1/5 보강
PICO 자동 추출 (휴리스틱, conf 3/4)
유사 논문P · Population 대상 환자/모집단
550 patients, 58% (321/550) were female and 77% (425/550) were White.
I · Intervention 중재 / 시술
lung resection for pathological stage I-IIIA NSCLC at a single institution [2010-2021] were identified
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
We identified 16% as the optimal emphysema score cut-point for predicting PAL, with sensitivity of 38%, specificity of 76%, and accuracy of 73%. [CONCLUSIONS] CT-based emphysema score is associated with PAL following lung cancer resection and may help guide intraoperative planning and patient counseling.
[BACKGROUND] Prolonged air leak (PAL) is a common complication after lung resection for non-small cell lung cancer (NSCLC).
- p-value P=0.02
- p-value P=0.040
- 95% CI 1.04-6.41
- OR 2.59
- Sensitivity 38%
- Specificity 76%
- 연구 설계 cohort study
APA
Naeem W, Khan AA, et al. (2025). CT-based emphysema score is associated with prolonged air leak after lung resection: a retrospective cohort study.. Journal of thoracic disease, 17(11), 9397-9410. https://doi.org/10.21037/jtd-2025-946
MLA
Naeem W, et al.. "CT-based emphysema score is associated with prolonged air leak after lung resection: a retrospective cohort study.." Journal of thoracic disease, vol. 17, no. 11, 2025, pp. 9397-9410.
PMID
41376978
Abstract
[BACKGROUND] Prolonged air leak (PAL) is a common complication after lung resection for non-small cell lung cancer (NSCLC). This retrospective cohort study investigates the association between computed tomography (CT)-based emphysema score and PAL in patients undergoing lung resection for NSCLC.
[METHODS] Patients who underwent lung resection for pathological stage I-IIIA NSCLC at a single institution [2010-2021] were identified. Exclusion criteria included neoadjuvant therapy, missing preoperative chest CT, pneumonectomy, or bilobectomy. Chest CT-based emphysema score was defined as the percentage of emphysematous lung [density <-950 Hounsfield units (HU)] in the ipsilateral lung. PALs were defined as those lasting more than 5 days. Univariable and multivariable logistic regression analyses were conducted.
[RESULTS] Among 550 patients, 58% (321/550) were female and 77% (425/550) were White. Approximately 67% (366/550) underwent a lobectomy, of which 67% (246/366) were upper lobe resections. Additionally, 79% (432/550) of patients underwent minimally-invasive surgery and 9% (48/550) developed a PAL. On multivariable analysis, after adjusting for age, gender, body mass index (BMI), surgical approach, lobe operated upon, procedure performed, pack-years and tumor size, percentage of emphysema [odds ratio (OR) =1.04; 95% confidence interval (CI): 1.01-1.07; P=0.02], lobectomy (OR =2.59; 95% CI: 1.04-6.41; P=0.040) and history of cardiothoracic surgery (OR =3.50; 95% CI: 1.53-8.03; P=0.003) were associated with PAL. We identified 16% as the optimal emphysema score cut-point for predicting PAL, with sensitivity of 38%, specificity of 76%, and accuracy of 73%.
[CONCLUSIONS] CT-based emphysema score is associated with PAL following lung cancer resection and may help guide intraoperative planning and patient counseling.
[METHODS] Patients who underwent lung resection for pathological stage I-IIIA NSCLC at a single institution [2010-2021] were identified. Exclusion criteria included neoadjuvant therapy, missing preoperative chest CT, pneumonectomy, or bilobectomy. Chest CT-based emphysema score was defined as the percentage of emphysematous lung [density <-950 Hounsfield units (HU)] in the ipsilateral lung. PALs were defined as those lasting more than 5 days. Univariable and multivariable logistic regression analyses were conducted.
[RESULTS] Among 550 patients, 58% (321/550) were female and 77% (425/550) were White. Approximately 67% (366/550) underwent a lobectomy, of which 67% (246/366) were upper lobe resections. Additionally, 79% (432/550) of patients underwent minimally-invasive surgery and 9% (48/550) developed a PAL. On multivariable analysis, after adjusting for age, gender, body mass index (BMI), surgical approach, lobe operated upon, procedure performed, pack-years and tumor size, percentage of emphysema [odds ratio (OR) =1.04; 95% confidence interval (CI): 1.01-1.07; P=0.02], lobectomy (OR =2.59; 95% CI: 1.04-6.41; P=0.040) and history of cardiothoracic surgery (OR =3.50; 95% CI: 1.53-8.03; P=0.003) were associated with PAL. We identified 16% as the optimal emphysema score cut-point for predicting PAL, with sensitivity of 38%, specificity of 76%, and accuracy of 73%.
[CONCLUSIONS] CT-based emphysema score is associated with PAL following lung cancer resection and may help guide intraoperative planning and patient counseling.