Current status of postoperative pulmonary complications and their predictive modeling in patients over 60 years of age undergoing thoracoscopic lobectomy
SUN Si-qi
LIU Xu
WANG Chun-hong
FU Yue
Abstract：Objective To explore the current situation of postoperative pulmonary complications(PPCs)in patients over 60 years of age who underwent thoracoscopic lobectomy and to construct a prediction model,with a view to providing clinical reference opinions.Methods A total of 328 lung cancer patients who underwent thoracoscopic lobectomy in the First Hospital of Harbin Medical University from June 2020 to December 2023 were selected as study subjects.According to whether PPCs occurred,the patients were divided into PPCs group and non-PPCS group.The clinical data of patients in the two groups were collected,and the influencing factors of the occurrence of PPCs were analyzed by multifactorial Logistic regression,and a prediction model was constructed based on the screened influencing factors.Results Among the 328 lung cancer patients,83(25.3%)were in the PPCs group and 245(74.7%)were in the non-PPCs group.The results of univariate analysis showed that compared with the non-PPCs group,the proportion of patients in the PPCs group with age＞75 years,diabetes mellitus,chronic obstructive pulmonary disease,hypoalbuminemia,neoadjuvant radiotherapy,preoperative debilitation,and the proportion of malnutrition increased,and the proportion of hemoglobin and preoperative pulmonary rehabilitation training decreased,with a statistically significant difference(P＜0.05).The results of multifactorial Logistic regression analysis showed that age＞75 years(OR=1.598,95%confidence interval:1.167-2.189),preoperative debility(OR=1.657,95%confidence interval:1.235-2.224),malnutrition(OR=1.846,95%confidence interval:1.259-2.706),low albuminemia(OR=1.677,95%confidence interval:1.253-2.245)were independent risk factors for the development of PPCs,and preoperative pulmonary rehabilitation training was a protective factor(OR=0.522,95%confidence interval:0.377-0.722).The receiver operating characteristic curve analysis showed that the model predicted the risk of the development of PPCs with an area under the curve of 0.861(95%confidence interval:0.812-0.909),with a sensitivity of 83.87%and a specificity of 78.16%.Conclusion Elderly lung cancer patients over 60 years of age have a higher risk of PPCs,and advanced age,malnutrition,preoperative debility,and hypoalbuminemia can increase the risk of PPCs,while preoperative pulmonary rehabilitation training can effectively improve lung function and reduce the incidence of PPCs,and the prediction model constructed accordingly can predict the risk of PPCs.
Keywords：ThoracoscopyLobectomyPulmonary complications
Publication Date：2024-08-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 227-232 )