Influencing Factors of Cardiopulmonary Complications after Thoracoscopic Surgery in Elderly Lung Cancer Patients and Development of A Nomogram Prediction Model
TAO Cunqian
WANG Aimei
WANG Jun
FU Chenghao
LIU Hairong
LU Siyu
ZHANG Lingling
CAO Juan
Abstract：Objective To explore the influencing factors of cardiopulmonary complications after thoracoscopic surgery in elderly patients with lung cancer and to construct a nomogram prediction model.Methods From July 2024 to January 2025,elderly lung cancer patients who underwent thoracoscopic resection and developed cardiopulmonary complications at the First Affiliated Hospital of Nanjing Medical University were included in the complication group(34 cases),while elderly lung cancer patients who underwent thoracoscopic resection without cardiopulmonary complications during the same period were included in the non-complication group(151 cases).Multivariate Logistic stepwise regression analysis was used to identify the influencing factors of cardiopulmonary complications after thoracoscopic surgery in elderly lung cancer patients.A nomogram was constructed,and its predictive value was evaluated using ROC curve analysis.Results The complication group had higher fasting blood glucose,age,intraoperative blood loss,operation time,low-density lipoprotein cholesterol,proportion of smokers,hypertension,diabetes,poor differentiation,and proportion of preoperative albumin<35 g/L compared to the non-complication group,while preoperative forced expiratory volume in one second/forced vital capacity ratio(FEV1/FVC%),forced expiratory volume in one second(FEV1),preoperative Barthel index score,hemoglobin,and high-density lipoprotein cholesterol levels were lower than those in the non-complication group(P<0.05).Multivariate Logistic stepwise regression analysis showed that advanced age,smoking,hypertension,prolonged operation time,and preoperative albumin<35 g/L were independent risk factors for cardiopulmonary complications after thoracoscopic surgery in elderly lung cancer patients(OR=1.689,95%CI:1.139-2.504,P=0.009;OR=2.790,95%CI:1.590-4.896,P<0.01;OR=3.077,95%CI:1.476-6.417,P=0.003;OR=1.960,95%CI:1.306-2.941,P=0.001;OR=2.927,95%CI:1.545-5.545,P=0.001).A higher preoperative FEV1/FVC%was an independent protective factor(OR=0.579,95%CI:0.393-0.851,P=0.005).The nomogram model had a consistency index of 0.897(95%CI:0.845-0.948).The area under the ROC curve of the nomogram for predicting cardiopulmonary complications after thoracoscopic surgery in elderly lung cancer patients was 0.876,with a sensitivity of 0.932 and a specificity of 0.689.Conclusion The nomogram model constructed based on influencing factors such as age,smoking,hypertension,operation time,preoperative FEV1/FVC%,and preoperative albumin has high predictive value for cardiopulmonary complications after surgery in elderly lung cancer patients.
Keywords：lung cancerelderly patientsthoracoscopic surgerycardiopulmonary complicationsnomogram
Publication Date：2025-11-20
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：6( 82-87 )