Department of Pharmacology, Kitasato University School of Medicine, Kanagawa, Japan; Department of Clinical Research Center, Kitasato University School of Medicine, Kanagawa, Japan.
Department of Thoracic Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
J Surg Res. 2015 Jan;193(1):442-8. doi: 10.1016/j.jss.2014.08.028. Epub 2014 Aug 30.
Recently, the Japanese Respiratory Society (JRS) proposed using lung age (LA) as an indicator of lung function; however, reports regarding the association of LA with the risk of postoperative readmission within 90 d after surgical treatment for non-small cell lung cancer (NSCLC) are limited. Here, we analyze the clinical relationship between LA and readmission within 90 d after surgical treatment for NSCLC.
A total of 979 patients underwent curative resections for NSCLC from January 2000-September 2012 at the Kitasato University Hospital. We selected patients who required readmission because of surgical complications within 90 d of surgery and retrospectively analyzed various clinical data. LA was calculated based on the formula given by the Japanese Respiratory Society, which relies on preoperative respiratory function. We also calculated the age gap (AG) between the calculated LA and the true age (TA).
There were 216 patients who needed to be readmitted within 90 d of surgery, 33 (3%) of whom were hospitalized for surgical complications. Twenty-four patients (73%) had respiratory complications, and 7 patients (21%) died. There were significant differences between the readmitted and no readmitted patients in terms of preoperative factors, such as gender, LA, AG, smoking status, and smoking index (P < 0.05). In addition, there were significant differences in intraoperative blood loss, postoperative complications, histologic type, duration of hospitalization, and hospitalization after surgery (P < 0.05). Multivariate analysis using logistic regression indicated that LA, AG, blood loss, and postoperative complications were independent factors that predicted readmission. Additionally, the 5-y survival rates were 78% and 44% for the no readmitted and readmitted groups, respectively (P < 0.001).
The AG between TA and LA was significantly associated with postoperative complications and remained an independent predictive factor after multiple regressions. LA was shown to be a useful factor for predicting the risk of surgery-related readmission within 90 d after surgery for NSCLC.
最近，日本呼吸学会（JRS）提出使用肺龄（LA）作为肺功能的指标；然而，关于 LA 与非小细胞肺癌（NSCLC）手术后 90 天内再次入院风险的相关性的报告有限。在这里，我们分析了 LA 与 NSCLC 手术后 90 天内再次入院之间的临床关系。
共有 979 例 NSCLC 患者于 2000 年 1 月至 2012 年 9 月在北里大学医院接受了根治性切除术。我们选择了因手术后 90 天内手术并发症而需要再次入院的患者，并回顾性分析了各种临床数据。LA 根据日本呼吸学会给出的公式计算，该公式依赖于术前呼吸功能。我们还计算了计算的 LA 与真实年龄（TA）之间的年龄差距（AG）。
有 216 例患者需要在手术后 90 天内再次入院，其中 33 例（3%）因手术并发症住院。24 例（73%）有呼吸系统并发症，7 例（21%）死亡。在术前因素方面，如性别、LA、AG、吸烟状态和吸烟指数，有再次入院和未再次入院的患者之间存在显著差异（P < 0.05）。此外，术中出血量、术后并发症、组织学类型、住院时间和术后住院时间也存在显著差异（P < 0.05）。使用逻辑回归的多变量分析表明，LA、AG、出血量和术后并发症是预测再次入院的独立因素。此外，无再次入院和再次入院组的 5 年生存率分别为 78%和 44%（P < 0.001）。
TA 和 LA 之间的 AG 与术后并发症显著相关，并且在多回归后仍然是一个独立的预测因素。LA 是预测 NSCLC 手术后 90 天内与手术相关再次入院风险的有用因素。
