Risk and outcomes of respiratory failure in elderly patients after thoracoscopic assisted radical lung cancer surgery: a retrospective cohort study
10.3760/cma.j.issn.0254-9026.2024.12.009
- VernacularTitle:胸腔镜辅助肺癌根治术后老年患者发生呼吸衰竭的风险和结果：回顾性队列研究
- Author:
Zhongyao XIE
1
;
Siyu YAO
;
Fan WANG
;
Qiuyue LIU
Author Information
1. 首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所感染管理处，北京 101149
- Publication Type:Journal Article
- Keywords:
Thoracic Surgical Procedures;
Aged;
Respiratory failure;
Early warning
- From:
Chinese Journal of Geriatrics
2024;43(12):1562-1567
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aims to analyze the clinical data of elderly patients who experienced respiratory failure after undergoing thoracoscopic-assisted radical lung cancer surgery.The objectives are to identify the risk factors associated with respiratory failure and to investigate the clinical significance of independent risk factors for the early prediction of respiratory failure in this patient population.Methods:A total of 42 elderly patients who developed respiratory failure following thoracoscopic-assisted radical lung cancer surgery at our hospital between January 1, 2021, and December 31, 2023, were continuously collected to form the observation group.Concurrently, a control group was established by randomly selecting elderly lung cancer patients who did not experience respiratory failure during the same period, in a 1: 1 ratio.Clinical data were collected from both groups, and logistic univariate and multivariate analyses were conducted.A receiver operating characteristic(ROC)curve was employed to evaluate the area under the curve(AUC), as well as the sensitivity and specificity of independent risk factors and their combinations.Results:The history of diabetes, PCT levels, and surgical day intake have been identified as independent risk factors for respiratory failure.Multivariate analysis revealed that a history of diabetes( OR: 1.29, 95% CI: 0.89-1.69; P=0.012), PCT( OR: 1.75, 95% CI: 1.51-2.38; P=0.005), and surgical day intake( OR: 1.42, 95% CI: 1.14-1.76; P<0.001)were significantly associated with the occurrence of postoperative respiratory failure.The area under the curve(AUC)values for predicting respiratory failure were 0.679, 0.679, and 0.740, respectively.The sensitivity and specificity for a history of diabetes were 41.2% and 87.1%; for PCT, 64.7% and 64.5%; and for surgical day intake, 70.6% and 74.2%.Notably, a combined model incorporating these three indicators produced an AUC of 0.918, with a sensitivity of 94.1% and a specificity of 80.6%. Conclusions:Following thoracoscopic-assisted radical lung cancer surgery, elderly patients with a history of diabetes, elevated PCT levels, and a daily fluid intake exceeding 2000 ml on the day of surgery demonstrate significant clinical value for the early detection of respiratory failure.
