Early and long-term validation of an algorithm assessing fitness for surgery in patients with postoperative FEV₁ and diffusing capacity of the lung for carbon monoxide < 40%.

Background: There is evidence in the literature that the incidence of pulmonary complications and mortality is fair enough in patients with lower pulmonary function than conventionally accepted. In this article, we validate in patients with low baseline lung function (ie, FEV(1) or diffusing capacity of the lung for carbon monoxide [DLCO] < 80%) an algorithm to evaluate anatomic lung surgery in patients with low predicted postoperative lung function (ie, either FEV(1)-postoperative estimated [ppo] or DLCO-ppo < 40% or both between 30% and 40% predicted) if peak oxygen uptake (VO(2)peak)-ppo > 10 mL/kg/min.

Methods: We prospectively studied 126 consecutive patients evaluated for anatomic resection of lung tumors by thoracotomy.