Glasgow Prognostic Score Class 2 Predicts Prolonged Intensive Care Unit Stay in Patients Undergoing Pneumonectomy

Ann Thorac Surg. 2016 Dec;102(6):1898-1904. doi: 10.1016/j.athoracsur.2016.05.111. Epub 2016 Aug 20.

Abstract

Background: The Glasgow prognostic score (GPS) is an inflammation-based score based on albuminemia and C-reactive protein concentration proved to be associated with cancer-specific survival in several neoplasms. The present study explored the immediate postoperative value of the GPS for patients undergoing pneumonectomy for lung cancer.

Methods: The value of the GPS preoperatively was studied in 250 patients undergoing pneumonectomy for non-small cell lung cancer (NSCLC). We analyzed overall postoperative complications, pulmonary and cardiac complications, 30-day postoperative death, reoperation for early complications, intensive care unit (ICU) length of stay and total length of hospital stay.

Results: Patients with a GPS of 0 and 1 had a mean ICU length of stay of 0.8 days, whereas patients with a GPS of 2 had a mean ICU stay of 5.0 days (p = 0.004). The postoperative mortality rate in patients with a GPS of 2 was much higher than in patients with a GPS of 1 and 2, although it was not statistically significant (p = 0.083).

Conclusions: A preoperative GPS of 2 effectively predicts a prolonged ICU stay in patients who undergo pneumonectomy for cancer. The score may be proposed as an easy-to-determine, economical, and fast preoperative tool to plan and optimize ICU admissions after elective pneumonectomy.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / analysis
  • Carcinoma, Non-Small-Cell Lung / blood
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Female
  • Hospital Mortality
  • Hospitalization / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Length of Stay* / statistics & numerical data
  • Lung Neoplasms / blood
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Pneumonectomy*
  • Postoperative Complications / blood*
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Postoperative Complications / surgery
  • Prognosis
  • Reoperation
  • Retrospective Studies
  • Serum Albumin / analysis
  • Severity of Illness Index*
  • Systemic Inflammatory Response Syndrome / blood*
  • Systemic Inflammatory Response Syndrome / etiology

Substances

  • Serum Albumin
  • C-Reactive Protein