Risk analysis of perioperative outcomes of lung transplantation and the prediction of delayed extubation
10.3760/cma.j.cn421203-20230326-00061
- VernacularTitle:肺移植围手术期预后风险因素分析及术后气管插管延迟拔管风险预测
- Author:
Peigen GAO
1
;
Lei ZHANG
;
Xiaxian SHEN
;
Pei ZHANG
;
Chenyang DAI
;
Yuping LI
;
Wenxin HE
;
Qiankun CHEN
;
Gening JIANG
;
Chang CHEN
Author Information
1. 同济大学附属上海市肺科医院胸外科 上海肺移植工程技术研究中心，上海 200433
- Keywords:
Lung transplantation;
Perioperative period;
Tracheal intubation;
Prognosis
- From:
Chinese Journal of Organ Transplantation
2023;44(11):645-652
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors of perioperative outcomes of lung transplantation and establish a predictive model for delayed extubation after lung transplantation.Methods:From January 1, 2020 to December 31, 2022, 104 lung transplantation recipients were retrospectively collected to identify the risk factors of early post-operative outcome.According to the timing of extubation post-lung transplantation, they were assigned into two groups of normal(77 cases)and delayed(27 cases). Baseline profiles, type of primary diagnosis, cold ischemic duration and lung transplantation approach were compared between two groups.The factors with significant difference were examined by univariate and multivariate Logistic regression.Furthermore, multivariate logistic model was visualized by a nomogram.Receiver operating characteristic(ROC)curve and decision curve analysis(DCA) were performed for evaluating the model's predictive performance and its value for clinical utilization.Results:The postoperative mortality rate was 9.6%.Delayed extubation was a strong predictor for postoperative mortality.Cold ischemic time outperformed others variates in terms of delayed extubation prediction.AUC of cold ischemic time and multivariate logistic model was 0.75(95% CI: 0.69-0.81)and 0.87(95% CI: 0.82-0.91). Conclusions:Delayed postoperative extubation is a key predictor of early post-lung transplantation mortality.The established predictive model may effectively identify high-risk patients for preventive intervention and survival improvement post-lung transplantation.
