Relationship between preoperative frailty and postoperative pulmonary complications in elderly patients undergoing thoracoscopic lobectomy
10.3760/cma.j.cn131073.20210618.00808
- VernacularTitle:胸腔镜肺叶切除术老年患者术前衰弱与术后肺部并发症的关系
- Author:
Dandan CHEN
1
;
Tingting FANG
;
Yi DING
;
Wenlan ZHU
;
Fenglai YUAN
;
Zhiqiang WANG
;
Nan DONG
;
Jiru ZHANG
Author Information
1. 江南大学附属医院麻醉科，无锡 214125
- Keywords:
Postoperative complications;
Lobectomy;
Thoracoscopy;
Aged;
Frailty
- From:
Chinese Journal of Anesthesiology
2021;41(8):928-932
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the relationship between preoperative frailty and postoperative pulmonary complications (PPCs) in elderly patients undergoing thoracoscopic lobectomy.Methods:The elderly patients with non-small cell lung cancer who underwent thoracoscopic lobectomy in the Affiliated Hospital of Jiangnan University were collected.The general data, frailty status, parameters of blood and operation-related parameters were recorded.The patients were divided into PPC group and non-PPC group according to whether PPCs occurred during hospitalization, and the differences between the parameters were compared.Logistic regression analysis was used to analyze the independent risk factors for PPCs.Stratification analysis and interaction test were used to further analyze the relationship between frailty and PPCs.Results:A total of 298 elderly patients with non-small cell lung cancer undergoing thoracoscopic lobectomy were included in this study, and the incidence of PPCs was 22.8%.Compared with non-PPC group, the albumin and FEV 1/FVC were decreased, and age, blood creatinine, ratio of diabetes mellitus, ratio of chronic obstructive pulmonary disease (COPD) and rate of preoperative frailty were significantly increased in PPC group ( P<0.05). The results of logistic regression analysis showed that COPD and preoperative frailty were independent risk factors for PPCs.After adjusting all the risk variables, the frail patients had a 171% increased risk of PPCs compared with non-frail patients ( OR value=2.71, 95%CI: 1.18-4.73, P<0.05). The results of subgroup analysis showed that body mass index and operation time had effect modification on the association between frailty and PPCs (interaction P<0.05). Conclusion:COPD and preoperative frailty are independent risk factors for PPCs in elderly patients undergoing thoracoscopic lobectomy, and the frail patients with obesity or long operation time are at higher risk of PPCs.
