Abstract 122P
Background
The Lee Revised Cardiac Risk Index (LCRI) has been recognized as a valuable tool for predicting cardiac complications. This study aims to investigate the utility of the LCRI in predicting postoperative complications and survival following robotic-assisted pulmonary lobectomy (RAPL).
Methods
We retrospectively analyzed consecutive patients who underwent RAPL over 11.8 years by one surgeon. Patients were grouped as having Low-Risk (LCRI=1) or High-Risk (LCRI>1). Demographics, preoperative comorbidities, perioperative complications and outcomes, and median survival time (MST) were compared between the two groups. Significant (p≤0.05) differences between the groups were determined by Chi-square/Fisher’s exact analysis, Student’s t-test, Mann-Whitney U test, and Kaplan-Meier analysis.
Results
Of 731 study patients, 526 patients had Low-Risk LCRI, and 205 had High-Risk LCRI. High-Risk LCRI patients were older (p<0.001) and had a larger proportion of male patients (p<0.001). High-Risk LCRI patients had greater estimated blood loss (p=0.030) and longer hospital length of stay (p=0.042) than Low-Risk LCRI patients. The incidence of intraoperative complications did not differ significantly between the two groups (p=0.497). However, High-Risk LCRI patients had greater incidences of myocardial infarctions and respiratory failure than Low-Risk LCRI patients. There was no significant difference in other postoperative cardiac complications between the two groups. Thirty-day mortality rates did not significantly differ for Low-Risk LCRI (1.7%) versus High-Risk LCRI (2.0%) patients (p=0.825). Median overall survival was 58.2 months for the High-Risk LCRI group versus 92.4 months for the Low-Risk LCRI group (p=0.002).
Conclusions
High-Risk LCRI patients had greater incidences of myocardial infarctions and respiratory failure. However, rates of other cardiac complications such as atrial fibrillation and arrhythmia did not differ between the two groups. While the LCRI remains a vital tool for assessing certain cardiac risks and overall survival postoperatively, its predictive capacity may not be uniform for all types of cardiac complications after RAPL.
Legal entity responsible for the study
The authors.
Funding
University of South Florida Health Morsani College of Medicine; Moffitt Cancer Center.
Disclosure
J. Fontaine, E.M. Toloza: Financial Interests, Personal, Other, Honoraria as robotic surgery observation site and proctor: Intuitive Surgical Corp. All other authors have declared no conflicts of interest.