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Table 5 Surgical risk assessment

From: Results of surgery for chronic pulmonary Aspergillosis, optimal antifungal therapy and proposed high risk factors for recurrence - a National Centre’s experience

Lower risk Higher risk
Risk of Aspergillus empyema
Intrapulmonary cavity Pleural involvement including thickening
Solid lesion Cavitary lesion with fungal ball or fluid level
Smooth-walled cavity Irregular or bumpy cavity surface (indicating fungal growth on surface of cavity)
Single lesion or small, localised collection of several interrelated lesions Extensive multicavity lesion
  Prior radiotherapy to proposed surgical site
  Prior lobectomy or other thoracic surgery
Risk of space infection
Localised lesion and lobectomy or segmental resection Second lobectomy or pneumonectomy
Chest wall normal Scoliosis or ankylosing spondylitis
  Other pleural/pulmonary disease preventing full lung mobilisation
  Immunosuppression
  Intrapleural spillage during surgery
Risk of overall poor outcome
Good pulmonary function FEV1 <1.0. L/sec
Young Older ( >70 years)
Well nourished Thin, low BMI or reduced albumin
No other significant comorbidities Diabetes, other concurrent pulmonary infection (ie non-tuberculous mycobacterial or Pseudomonas infection)
  Other associated significant comorbidities (i.e. lymphoma, autoimmune hepatitis, organ transplantation)