Zhang Wenbiao, Li Shuangjiang, Chen Longqi, Zhou Qinghua
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Interact Cardiovasc Thorac Surg. 2019 Aug 1;29(2):291–294. doi: 10.1093/icvts/ivz084. Epub 2019 Mar 19.
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether low serum albumin (sAlb) was associated with postoperative bronchopleural fistula (BPF) in patients undergoing pulmonary resections. Altogether 660 papers were found using the reported search, of which 5 retrospective cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Four of the 5 cohort studies showed that the preoperative sAlb level in patients who experience a BPF was significantly lower than that in patients who did not experience a BPF. One of the 5 studies also reported that the incidence of BPF in patients with a lower sAlb (13.6%) was found to be significantly higher than that in patients with a higher sAlb (7.0%). The level of hypoalbuminaemia is not defined, but it may be <3.5 g/dl. This cut-off value of sAlb is assumed from the currently available retrospective data. No prospective study has been reported to address this issue. In summary, low preoperative sAlb can serve as a significant risk factor for postoperative BPF in patients undergoing pulmonary resections.
根据结构化方案撰写了一篇胸外科最佳证据主题文章。所探讨的问题是，肺切除患者血清白蛋白（sAlb）水平低是否与术后支气管胸膜瘘（BPF）相关。通过报告的检索共找到660篇论文，其中5项回顾性队列研究代表了回答该临床问题的最佳证据。现将这些论文的作者、期刊、发表日期、国家、研究的患者组、研究类型、相关结局和结果制成表格。5项队列研究中有4项表明，发生BPF的患者术前sAlb水平显著低于未发生BPF的患者。5项研究中的1项还报告称，sAlb水平较低的患者中BPF的发生率（13.6%）显著高于sAlb水平较高的患者（7.0%）。低白蛋白血症的水平未明确界定，但可能<3.5 g/dl。该sAlb临界值是根据目前可用的回顾性数据推断得出的。尚未有前瞻性研究报道该问题。总之，术前sAlb水平低可作为肺切除患者术后发生BPF的重要危险因素。
