ArticleJournal of thoracic disease2025
CT-based emphysema score is associated with prolonged air leak after lung resection: a retrospective cohort study.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Endoluminal approaches to postoperative air leaks.Journal of thoracic disease · 2026Review
- Preoperative CT-based emphysema score: a tool to inform not determine prolonged air leak risk after lung cancer resection.Journal of thoracic disease · 2026Article
- Surgical implications of CT-based emphysema scoring in predicting prolonged air leak-defining its role as a risk stratification tool rather than a decision trigger.Journal of thoracic disease · 2026Article
- From Alveolar Injury to Precision Perioperative Care: Integrating Molecular Biomarkers and Technology-Enabled Strategies for Prolonged Air Leak After Lung Resection.Mediators of inflammation · 2026Review
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9 authors.
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Abstract
Background: Prolonged air leak (PAL) is a common complication after lung resection for non-small cell lung cancer (NSCLC). This retrospective cohort study investigates the association between computed tomography (CT)-based emphysema score and PAL in patients undergoing lung resection for NSCLC. Methods: Patients who underwent lung resection for pathological stage I-IIIA NSCLC at a single institution [2010-2021] were identified. Exclusion criteria included neoadjuvant therapy, missing preoperative chest CT, pneumonectomy, or bilobectomy. Chest CT-based emphysema score was defined as the percentage of emphysematous lung [density <-950 Hounsfield units (HU)] in the ipsilateral lung. PALs were defined as those lasting more than 5 days. Univariable and multivariable logistic regression analyses were conducted. Results: Among 550 patients, 58% (321/550) were female and 77% (425/550) were White. Approximately 67% (366/550) underwent a lobectomy, of which 67% (246/366) were upper lobe resections. Additionally, 79% (432/550) of patients underwent minimally-invasive surgery and 9% (48/550) developed a PAL. On multivariable analysis, after adjusting for age, gender, body mass index (BMI), surgical approach, lobe operated upon, procedure performed, pack-years and tumor size, percentage of emphysema [odds ratio (OR) =1.04; 95% confidence interval (CI): 1.01-1.07; P=0.02], lobectomy (OR =2.59; 95% CI: 1.04-6.41; P=0.040) and history of cardiothoracic surgery (OR =3.50; 95% CI: 1.53-8.03; P=0.003) were associated with PAL. We identified 16% as the optimal emphysema score cut-point for predicting PAL, with sensitivity of 38%, specificity of 76%, and accuracy of 73%. Conclusions: CT-based emphysema score is associated with PAL following lung cancer resection and may help guide intraoperative planning and patient counseling.
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