Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Sci Rep. 2020 Jul 24;10(1):12385. doi: 10.1038/s41598-020-68929-9.
Postoperative pulmonary complications (PPCs) significantly impact surgical outcome. We investigated the predictive ability of controlling nutritional status (CONUT) for PPC after lung resection in patients with non-small cell lung cancer (NSCLC). We retrospectively reviewed data of 922 patients with NSCLC who underwent complete resection from January 2016-December 2017. We analyzed the frequency and characteristics of PPCs and compared receiver operating characteristic (ROC) curves of various prognostic models to predict PPCs. A CONUT score higher than 1 was considered as a high CONUT score. Total incidence of PPCs was 8.6% (n = 79). The proportion of pneumonia was significantly larger in the high CONUT group (P < 0.05). The CONUT consistently had a higher area under curve (AUC) value (0.64) than other prognostic models (prognostic nutritional index (PNI): AUC = 0.61, Glasgow prognostic score (GPS): AUC = 0.57, and assessment of respiratory risk in surgical patients in Catalonia (ARISCAT): AUC = 0.54). Multivariate analysis identified underweight [Odds ratio (OR) = 4.57, P = 0.002] and high CONUT score (OR = 1.91, P = 0.009) as independent PPCs prognostic factors. One-year mortality rate for high CONUT score was significantly higher (hazard ratio = 7.97; 95% confidence interval, 1.78-35.59). Preoperative CONUT score is an independent predictor of PPCs and 1-year mortality in patients with resectable NSCLC.
术后肺部并发症（PPCs）显著影响手术结果。我们研究了控制营养状况（CONUT）对非小细胞肺癌（NSCLC）患者肺切除术后 PPC 的预测能力。我们回顾性分析了 2016 年 1 月至 2017 年 12 月期间接受完全切除术的 922 例 NSCLC 患者的数据。我们分析了 PPC 的频率和特征，并比较了各种预测模型的接收者操作特征（ROC）曲线，以预测 PPCs。CONUT 评分高于 1 被认为是高 CONUT 评分。PPCs 的总发生率为 8.6%（n=79）。高 CONUT 组肺炎的比例明显更大（P<0.05）。CONUT 始终具有比其他预后模型（预后营养指数（PNI）：AUC=0.61、格拉斯哥预后评分（GPS）：AUC=0.57、加泰罗尼亚外科患者呼吸风险评估（ARISCAT）：AUC=0.54）更高的曲线下面积（AUC）值。多变量分析确定体重不足（优势比（OR）=4.57，P=0.002）和高 CONUT 评分（OR=1.91，P=0.009）为独立的 PPCs 预后因素。高 CONUT 评分的 1 年死亡率明显更高（危险比=7.97；95%置信区间，1.78-35.59）。术前 CONUT 评分是可切除 NSCLC 患者 PPCs 和 1 年死亡率的独立预测因素。
