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食管癌切除术后癌症患者肺部并发症预测评分的评估。

Assessment of a predictive score for pulmonary complications in cancer patients after esophagectomy.

作者信息

Xing Xue-Zhong, Gao Yong, Wang Hai-Jun, Qu Shi-Ning, Huang Chu-Lin, Zhang Hao, Wang Hao, Yang Quan-Hui

机构信息

Department of Intensive Care Unit, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

World J Emerg Med. 2016;7(1):44-9. doi: 10.5847/wjem.j.1920-8642.2016.01.008.

Abstract

BACKGROUND

Esophagectomy is a very important method for the treatment of resectable esophageal cancer, which carries a high rate of morbidity and mortality. This study was undertaken to assess the predictive score proposed by Ferguson et al for pulmonary complications after esophagectomy for patients with cancer.

METHODS

The data of patients who admitted to the intensive care unit after transthoracic esophagectomy at Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College between September 2008 and October 2010 were retrospectively reviewed.

RESULTS

Two hundred and seventeen patients were analyzed and 129 (59.4%) of them had postoperative pulmonary complications. Risk scores varied from 0 to 12 in all patients. The risk scores of patients with postoperative pulmonary complications were higher than those of patients without postoperative pulmonary complications (7.27±2.50 vs. 6.82±2.67; P=0.203). There was no significant difference in the incidence of postoperative pulmonary complications as well as in the increase of risk scores (χ (2)=5.477, P=0.242). The area under the curve of predictive score was 0.539±0.040 (95%CI 0.461 to 0.618; P=0.324) in predicting the risk of pulmonary complications in patients after esophagectomy.

CONCLUSION

In this study, the predictive power of the risk score proposed by Ferguson et al was poor in discriminating whether there were postoperative pulmonary complications after esophagectomy for cancer patients.

摘要

背景

食管切除术是治疗可切除食管癌的一种非常重要的方法,但该手术的发病率和死亡率很高。本研究旨在评估Ferguson等人提出的预测食管癌患者食管切除术后肺部并发症的评分系统。

方法

回顾性分析2008年9月至2010年10月在中国医学科学院肿瘤医院及北京协和医学院行开胸食管切除术后入住重症监护病房的患者资料。

结果

共分析217例患者,其中129例(59.4%)发生术后肺部并发症。所有患者的风险评分在0至12分之间。发生术后肺部并发症患者的风险评分高于未发生术后肺部并发症的患者(7.27±2.50 vs. 6.82±2.67;P=0.203)。术后肺部并发症的发生率以及风险评分的增加无显著差异(χ²=5.477,P=0.242)。预测评分的曲线下面积为0.539±0.040(95%CI 0.461至0.618;P=0.324),用于预测食管癌患者食管切除术后肺部并发症的风险。

结论

在本研究中,Ferguson等人提出的风险评分在鉴别癌症患者食管切除术后是否发生术后肺部并发症方面预测能力较差。

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本文引用的文献

1
Correlation of fluid balance and postoperative pulmonary complications in patients after esophagectomy for cancer.
J Thorac Dis. 2015 Nov;7(11):1986-93. doi: 10.3978/j.issn.2072-1439.2015.11.24.
3
External validation of the Ferguson pulmonary risk score for predicting major pulmonary complications after oesophagectomy†.
Eur J Cardiothorac Surg. 2016 Jan;49(1):333-8. doi: 10.1093/ejcts/ezv021. Epub 2015 Feb 26.
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Risk factors and prognosis of critically ill cancer patients with postoperative acute respiratory insufficiency.
World J Emerg Med. 2013;4(1):43-7. doi: 10.5847/wjem.j.issn.1920-8642.2013.01.008.
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Risk factors for postoperative respiratory complications following esophageal cancer resection.
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