“Surviving Pneumonectomy: Identifying key determinants and outcomes.”

Abstract

Abstract Background: Pneumonectomy is a surgical procedure that involves the complete removal of a lung and was first performed in 1933 by Evarts A. Graham for lung carcinoma. Despite its efficacy in treating lung diseases, Pneumonectomy is associated with high morbidity and mortality rates compared to other lung resection procedures. Methods: This retrospective case-control study included 180 patients who underwent Pneumonectomy or Other lung resection at TASH between January 2017 and December 2022. Data were collected using a checklist by trained data collectors and analyzed using SPSS V.25. Univariate, bivariate, and multivariate analyses were conducted to identify determinants of Pneumonectomy. The Pearson's chi-square test, COR, and AOR were calculated for categorical variables, where appropriate. Binary logistic regression models were computed to identify determinants of Pneumonectomy, and odds ratios with 95% confidence intervals were calculated. Results: The majority of patients who underwent Pneumonectomy were in the 20-30 age range (48.2%), with a male to female ratio of 1.6:1. Emergency admission (AOR, 3.43; 95%CI: 1.28, 8.67), TB treatment history (AOR, 40.3; 95%CI: 3.01, 540.2), blood loss (AOR, 9.07; 95%CI: 1.04, 79.13), ICU stay (AOR, 0.02; 95%CI: 0.001, 0.17), and post-operative complications (AOR, 37.9; 95%CI: 1.82, 792) were identified as significant determinants of Pneumonectomy. Conclusion: This study identified several determinants of Pneumonectomy, including emergency admission, TB treatment history, blood loss, ICU stay, and post-operative complications. The study recommends a focus on TB prevention strategies and proper patient evaluation before treatment at all health facility levels to improve patient outcomes and reduce the incidence of postoperative complications.