Factors associated with air leak prolongation observed after lung cancer surgery

PURPOSE: Risk factors that classify patients with postoperative air leaks into prolonged-air-leak (PAL, ≥ 5 days) and non-PAL populations remain unknown. Our objectives were to identify these risk factors and devise a scoring system to predict whether air leaks observed on postoperative day 1 will progress to PAL. METHODS: We conducted a retrospective examination of 329 patients after lung surgery. RESULTS: Significant factors associated with air leaks included male sex (p = 0.0097), low body mass index (BMI) (p = 0.0016), smoking (p = 0.0076), pack-years (0.0017), predicted vital capacity (p = 0.0053), predicted forced expiratory volume in one second (p = 0.0352), and operative duration (p = 0.0118). Furthermore, in patients with air leaks on the day after surgery, significant factors associated with PAL included low BMI (p = 0.0248), current smoking (p = 0.0054), pack-years (p = 0.005), and significant blood loss (p = 0.0147). Upon classifying the patients on day 1, one point each was allotted for BMI < 23.7, pack-years ≥ 28.5, current smoker, and blood loss ≥ 38 ml. Depending upon the risk factors present, the rates of PAL observed were 0%, 7.69%, 33.33%, 70.59%, and 83.33% associated with 0, 1, 2, 3, and 4 points, respectively (p < 0.001). CONCLUSIONS: For the first time, we identified risk factors for the onset of postoperative air leakage and PAL.