Huh Jin, Sohn Tae-Sung, Kim Jin-Kyoung, Yoo Yeon-Kyeong, Kim Duk-Kyung
Department of Anaesthesiology and Pain Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Centre, Seoul, Republic of Korea.
J Int Med Res. 2013 Aug;41(4):1301-9. doi: 10.1177/0300060513489470.
To identify predictors of postoperative pulmonary complications (PPCs) in patients aged ≥ 60 years who underwent laparoscopy-assisted gastrectomy (LAG), and to examine the value of preoperative spirometry to predict PPCs.
Patients with preoperative spirometric results who underwent LAG were retrospectively studied. Spirometry included four parameters: forced expiratory volume in 1 s; functional vital capacity; mean forced expiratory flow during middle of functional vital capacity; peak expiratory flow rate.
Of 213 patients, overall incidence of PPCs was 19.2%. Abnormal spirometry findings were not identified as an independent predictor of PPCs using multivariate logistic regression analysis. Age was found to be the only independent predictor of PPCs out of all variables evaluated. Separate assessment of individual spirometric parameters using receiver-operating curve analyses indicated poor diagnostic accuracy.
Preoperative spirometry was not reliably predictive of PPCs, either as combined or individual parameters, in patients aged ≥ 60 years who underwent LAG. These results do not support routine use of spirometry to stratify risk of PPCs in this surgical population.
确定接受腹腔镜辅助胃切除术（LAG）的60岁及以上患者术后肺部并发症（PPC）的预测因素，并探讨术前肺活量测定对预测PPC的价值。
对接受LAG且有术前肺活量测定结果的患者进行回顾性研究。肺活量测定包括四个参数：第1秒用力呼气量；功能肺活量；功能肺活量中期的平均用力呼气流量；呼气峰值流速。
在213例患者中，PPC的总体发生率为19.2%。使用多因素逻辑回归分析，肺活量测定异常结果未被确定为PPC的独立预测因素。在所有评估变量中，年龄是唯一被发现的PPC独立预测因素。使用受试者工作特征曲线分析对各个肺活量测定参数进行单独评估，结果显示诊断准确性较差。
对于接受LAG的60岁及以上患者，术前肺活量测定无论是作为综合参数还是单个参数，都不能可靠地预测PPC。这些结果不支持在该手术人群中常规使用肺活量测定来分层PPC风险。
