Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.
Ann Thorac Surg. 2018 Nov;106(5):1548-1555. doi: 10.1016/j.athoracsur.2018.05.049. Epub 2018 Jun 19.
There are no published reports on predictors of oxygen (O) use after lung cancer surgery. The prospect of O use after lung cancer surgery may affect a patient's therapy choice.
The Surveillance, Epidemiology, and End Results (SEER)-Medicare data set was queried to identify patients diagnosed with primary lung cancer (stage I/II) who underwent surgical resection from 1994 to 2010. Patients with a second resection within 6 months of their first and those with preoperative O use were excluded. Multivariable logistic regression was performed to evaluate the odds ratios and 95% confidence intervals of O use (defined as being billed for home O) after discharge for lung cancer surgery.
Of 21,245 eligible patients from 1994 to 2010, 3,255 (15.3%) were billed for O use in the first month of discharge. Of these, 13.7% (447 of 3,255) stopped using within 1 month, and 1.47% died. By 6 months, an additional 6.7% died, and 46.27% (1,384 of 2,991) were still alive and using O Discharge on O was associated with higher odds of death within 6 months (odds ratio, 1.35; 95% confidence interval, 1.17 to 1.55). The significant, independent risk factors for O use at discharge were procedure, sex, race, histology, pulmonary comorbidities, obesity, length of stay, pulmonary complications, and discharge mode.
Home O use after lung cancer surgery comprises a sizable portion of this population and is correlated with death in the first 6 months. Various predictors significantly increased the risk of O use at discharge. However, 49.3% of those originally discharged on O were alive and off O at 6 months.
目前尚无关于肺癌手术后氧疗(Oxygen,O)使用预测因素的报道。肺癌手术后使用 O 的可能性会影响患者的治疗选择。
通过检索监测、流行病学和最终结果(Surveillance, Epidemiology, and End Results, SEER)-医疗保险数据库,确定 1994 年至 2010 年间接受手术切除的原发性肺癌(I/II 期)患者。排除 6 个月内再次切除和术前使用 O 的患者。采用多变量逻辑回归分析评估肺癌手术后出院后使用 O(定义为家庭 O 计费)的优势比(odds ratio,OR)和 95%置信区间(confidence interval,CI)。
在 1994 年至 2010 年间的 21245 名合格患者中,有 3255 名(15.3%)在出院后第一个月内计费使用 O。其中,13.7%(447/3255)在 1 个月内停止使用,1.47%死亡。6 个月时,又有 6.7%死亡,46.27%(1384/2991)仍存活并使用 O。出院时使用 O 与 6 个月内死亡的几率较高相关(OR,1.35;95%CI,1.17 至 1.55)。出院时使用 O 的独立显著危险因素为手术方式、性别、种族、组织学、肺部合并症、肥胖、住院时间、肺部并发症和出院方式。
肺癌手术后家庭 O 治疗占该人群的相当大比例,并与前 6 个月内的死亡相关。各种预测因素显著增加了出院时使用 O 的风险。然而,49.3%最初出院时使用 O 的患者在 6 个月时存活且不再使用 O。