One-third of patients with TB-destroyed lung may have postoperative complications

Approximately one-third of patients with tuberculosis-destroyed lung experienced postoperative complications, with certain subgroups at higher risk, according to new data published in BMC Pulmonary Medicine.

“Few studies have demonstrated that the high mortality of patients undergoing surgery is majorly due to concurrent medical problems,” Hongyun Ruan, BM, from the department of cardiopulmonary function at Beijing Chest Hospital at Capital Medical University, and colleagues wrote. “Identifying which patients are at greatest risk of developing complications and which types of complications are life threatening is essential for reducing the mortality of TB-destroying lung.”

Researchers evaluated data from 113 consecutive patients with TB-destroyed lung (mean age, 39.2 years; 54.9% women) who underwent surgery at the Beijing Chest Hospital from January 2001 to September 2019. Smoking history, medical history, blood examination, pulmonary function test and chest CT were collected for all patients at baseline.

Postoperative complications included death during admission or within 30 days after surgery, heart failure, respiratory failure with mechanical ventilation, sepsis and postoperative bleeding.

Thirty-three patients (29.2%) experienced postoperative complications, with respiratory failure in 15.1%, infection in 5.3%, chest hemorrhage in 5.3% and heart failure in 3.5%.

Compared with patients with a normal BMI, patients with a lower BMI were more likely to experience a postoperative complication (adjusted OR = 6.33; 95% CI, 1.95-20.5).Patients with a BMI of 25 kg/m² or higher had significantly lower postoperative complication rates (aOR = 0.72; 95% CI, 0.12-4.38). In addition, patients with a history of smoking had significantly increased postoperative complication rates (aOR = 5.59; 95% CI, 1.51-21.33).

Researchers reported significantly higher odds of postoperative complications among patients with underlying infections such as aspergillus and non-TB mycobacteria compared with patients without underlying infection (aOR = 4.03; 95% CI, 1.38-11.76). In addition, anemia was identified as an independent risk factor associated with postoperative complications in unadjusted (OR = 10.5; 95% CI, 2.05-53.74) and adjusted models (aOR = 9.63; 95% CI, 1.27-73.06).

Compared with patients with a blood transfusion of 1,000 mL or lower, patients with a blood transfusion above 1,000 mL had an increased frequency for postoperative complications in both unadjusted (OR = 5.27; 95% CI, 1.05-13.31) and adjusted models (aOR = 4.91; 95% CI, 1.64-14.63).

“Our findings emphasize the importance of early interventions in risk groups to prevent adverse outcomes in tuberculosis-destroyed lung patients,” the researchers wrote.