Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Surg Today. 2010 Nov;40(11):1027-33. doi: 10.1007/s00595-009-4182-7. Epub 2010 Nov 3.
The purpose of this study was to identify the risk factors for postoperative pulmonary complications and to develop a scoring system to predict the surgical outcomes in lung cancer patients.
Clinical data were collected from January 1990 to March 2007 for 1713 patients who underwent lung cancer surgery at Chiba University Hospital. Between January 1990 and December 2000, 1032 evaluation subjects' data were used to identify risk factors for postoperative pulmonary complications (PC). These factors were subclassified into grades to develop a scoring system to predict surgical outcomes. This scoring system was applied to 681 test patients between January 2001 and March 2007.
Postoperative PC were present in 115 (11.1%) evaluation subjects. Multivariate analyses revealed six risk factors associated with postoperative PC: male, advanced age, preoperative interstitial pneumonia, high smoking index, combined resection, and vascular and/or bronchial reconstruction. Each risk factor was scored from 0 to 2 or 3, based on the frequency of the PC. The sum of these scores provided a total risk index (TRI: Sekine score). There was a significant correlation between the frequency of PC and the TRI (R (2) = 0.957, P < 0.0001). Fifty-one of the test subjects had PC (7.5%). They also showed a significant correlation between the PC and TRI (R (2) = 0.946, P < 0.0001).
The TRI was a valuable scoring system for predicting postoperative pulmonary complications.
本研究旨在确定肺癌术后肺部并发症的危险因素，并建立一种评分系统来预测肺癌患者的手术结果。
收集了 1990 年 1 月至 2007 年 3 月在千叶大学医院接受肺癌手术的 1713 例患者的临床资料。1990 年 1 月至 2000 年 12 月，1032 例评估对象的数据用于确定术后肺部并发症（PC）的危险因素。这些因素分为不同等级，以建立一种评分系统来预测手术结果。该评分系统应用于 2001 年 1 月至 2007 年 3 月的 681 例测试患者。
115 例（11.1%）评估对象发生术后 PC。多变量分析显示，与术后 PC 相关的 6 个危险因素为：男性、高龄、术前间质性肺炎、高吸烟指数、联合切除术和血管和/或支气管重建。每个危险因素的评分根据 PC 的发生频率为 0-2 或 3 分。这些评分的总和提供了一个总风险指数（Sekine 评分）。PC 的发生率与 TRI 之间存在显著相关性（R²=0.957，P<0.0001）。51 例测试对象发生 PC（7.5%）。PC 与 TRI 之间也存在显著相关性（R²=0.946，P<0.0001）。
TRI 是一种预测术后肺部并发症的有价值的评分系统。
