The Value of the Pulmonary Artery Pulsatility Index in Predicting Acute Kidney Injury After Thoracoscopic Radical Resection of Lung Cancer
GUI Yang
WANG Jiawu
ZENG Rong
ZHANG Chaofeng
FANG Yun
YANG Yue
TANG Chaoliang
Abstract：Objective To investigate the predictive value of the pulmonary artery pulsatility index(PAPI)for acute kidney injury(AKI)after radical thoracoscopic lung cancer resection.Methods A total of 320 patients who underwent elective radical thoracoscopic lung cancer resection at the First Affiliated Hospital of University of Science and Technology of China between January 2022 and September 2024 were selected.According to the occurrence of AKI after surgery,they were divided into an AKI group(n=46)and a non-AKI group(n=274).General clinical data were compared between the two groups;preoperative PAPI was measured using echocardiography;multivariate logistic regression analysis was used to identify independent risk factors for AKI after radical lung cancer resection;and receiver operating characteristic(ROC)curves were employed to evaluate the predictive value of PAPI.Results The AKI group had lower preoperative albumin(ALB),high-density lipoprotein cholesterol,estimated glomerular filtration rate(eGFR),and PAPI than the non-AKI group,and a higher proportion of vasoactive drug use(P<0.05).Multivariate logistic regression analysis showed that increased preoperative ALB,elevated eGFR,and higher PAPI were independent protective factors against AKI after radical lung cancer surgery(OR=0.695,95%CI:0.594-0.813,P<0.001;OR=0.867,95%CI:0.818-0.919,P<0.001;OR=0.274,95%CI:0.176-0.428,P<0.001).ROC curve analysis revealed that the AUCs of preoperative ALB,eGFR,and PAPI for predicting AKI were 0.716,0.803,and 0.863,respectively.The AUC of PAPI was significantly higher than that of ALB and eGFR(ZALB=2.720,PALB=0.007;ZeGFR=2.151,PeGFR=0.016).The cutoff value of PAPI was 4.695,with a sensitivity of 89.40%and a specificity of 71.70%.Additionally,patients with higher PAPI levels had significantly shorter hospital stays than those with lower PAPI levels(P<0.001).Conclusion Increased preoperative ALB,elevated eGFR,and higher PAPI are protective factors against AKI after radical lung cancer resection.Among these,PAPI demonstrates high predictive accuracy for postoperative AKI.
Keywords：pulmonary artery pulsatility indexthoracoscopic radical lung cancer resectionacute kidney injurylung cancer
Publication Date：2025-10-20
Online Publishing Date：2025-10-28(First online date of this platform, not the publication date of the document)
Pages：5( 56-60 )