RT Journal Article
T1 American College of Chest Physicians algorithm for lung resective surgery: Real-life validation
A1 Puente Maestu, Luis
A1 Benedetti, Paola
A1 García De Pedro, Julia
A1 García, Javier
A1 Castro, Christian
A1 Garutti Martínez, Ignacio
A1 Simón Adiego, Carlos María
AB Rationale: The preoperative evaluation of candidates for resective surgery has been addressed in several guidelines, the most recent is the American College of Chest Physicians (ACCP) algorithm; however, validating information in routine clinical practice is scant.Methods: This is a retrospective cohort study based on an ongoing registry of candidates for thoracic surgery that began in 2011; therefore, relevant data were prospectively collected. This study is based on patients who operated from January 2011 to 16 December 2023. The last survival update was done on 16 March 2024.Results: Overall, postoperative mortality increased from 3.1% at 30 days to 5.5% at 90 days. Factors associated with mortality included age, predicted-postoperative (PPO) FEV1, PPO-DLco, intermediate ACCP risk and pneumonectomy. Video-assisted thoracic surgery (VATS) reduced risk. When adjusted for covariates, independent risk factors were age, ACCP intermediate risk and pneumonectomy. Thirty-day mortality: age >70 years OR = 7.5 (95% CI 2.1-26.6), ACCP intermediate risk = 5.6 (1.2-25.8) and pneumonectomy = 6.5 (1.7-24.8); 60-day mortality: age >70 = 10.5 (3.0-37.1), ACCP intermediate risk = 4.5 (1.22-16.33) and pneumonectomy = 8.2 (2.2-29.3); 90-day mortality, age >70 = 6.5 (1.1-24.8), ACCP intermediate risk = 8.2 (2.3-29.26), pneumonectomy = 8.1 (2.78-24.3).Conclusions: The ACCP algorithm remains a valid tool for the assessment of fitness for anatomical lung resection. Our data support some reworking of the algorithm (i.e. considering age >70 years and pneumonectomy in the decision algorithm as intermediate-risk determinants). Mortality continues to increase from 30 to 90 days with higher risk, and this should be considered in the risk/benefit analysis of therapeutic alternatives.
PB Taylor & Francis
SN 2531-0429
YR 2026
FD 2026-02-09
LK https://hdl.handle.net/20.500.14352/137129
UL https://hdl.handle.net/20.500.14352/137129
LA eng
NO Puente-Maestu, L., Benedetti, P., Garcia de Pedro, J., García, J., Castro, C., Garutti, I., & Simon, C. (2026). American College of Chest Physicians algorithm for lung resective surgery: Real-life validation. Pulmonology, 32(1). https://doi.org/10.1080/25310429.2026.2625574
DS Docta Complutense
RD 6 jul 2026