Scoring system predicts postoperative complication in IPF patients with NSCLC

A novel scoring system has shown its capacity in predicting postoperative pulmonary complications in patients with non-small cell lung cancer (NSCLC) and idiopathic pulmonary fibrosis (IPF), reports a study.

“This novel scoring system consisting of six easily accessible clinical variables may help predict postoperative pulmonary complications and guide treatment decisions,” the researchers said.

A total of 225 patients were included in the analysis. The participants comprised two cohorts: those who were diagnosed with IPF and those who underwent curative resection for NSCLC.

The research team developed a scoring system to predict postoperative pulmonary complications based on regression coefficients derived from a multivariable logistic regression model that included the following: age, sex, diabetes, American Society of Anesthesiologists, diffusing capacity, and extent of surgery. This was validated through discrimination and calibration using a separate cohort of 51 patients.

Postoperative pulmonary complications occurred in 95 patients (34 percent).

Six predictors were included in the final scoring model, resulting in a total score of 0‒10 points: age ≥65 years (1 point), male (1 point), American Society of Anesthesiologists class ≥3 (1 point), diabetes (2 point), diffusing capacity ≤65 percent (2 point), and extent of surgery (3 points).

The scoring system had an area under the curve of 0.75 (95 percent confidence interval [CI], 0.69‒0.82) in the derivation cohort and 0.73 (95 percent CI, 0.57‒0.88) in the validation cohort.

“Postoperative pulmonary complications are common and can be fatal in patients with IPF undergoing lung cancer surgery,” the researchers said.