Shao Weipeng, Zhang Zhenrong, Zhang Jun, Feng Hongxiang, Liang Chaoyang, Liu Deruo
Department of General Thoracic Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.
Department of General Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China.
J Thorac Dis. 2020 Nov;12(11):6670-6679. doi: 10.21037/jtd-20-2264.
The objective of this retrospective study is to evaluate the impact of the CCI on short-term outcomes in pulmonary resection.
We retrospectively analyzed 1,309 patients who underwent pulmonary surgery consecutively in our hospital.
All patients were divided into complication group and non-complication group. CCI (P=0.012), blood loss (P=0.015) and type of surgery (P<0.001) were an independent risk factors for complications in multivariate analysis. Assuming a threshold of 3 for defining poor outcomes for pulmonary resection, the sensitivity and specificity were 87.9% and 44.2%, respectively. The area under the curve for CCI was 0.711 (P<0.001). There were 918 (70.1%) patients in the CCI ≤3 group and 391 (29.9%) patients in the CCI ≤3 group. The rate of poor outcome was 3.3% in the CCI ≤3 group, and 9.2% in the CCI >3 group (P<0.001).
The main finding of the present study was that CCI >3 was associated with a poor short-term outcome. For patients with CCI >3, it was suggested that the experienced surgical team should perform pulmonary resection in the shortest time and preserving the lung function as much as possible.
本回顾性研究的目的是评估美国麻醉医师协会（ASA）分级对肺切除术后短期预后的影响。
我们回顾性分析了我院连续接受肺手术的1309例患者。
所有患者分为并发症组和无并发症组。在多因素分析中，ASA分级（P=0.012）、失血量（P=0.015）和手术类型（P<0.001）是并发症的独立危险因素。假设将肺切除术后不良预后的阈值定义为3，其敏感性和特异性分别为87.9%和44.2%。ASA分级的曲线下面积为0.711（P<0.001）。ASA分级≤3组有918例（70.1%）患者，ASA分级>3组有391例（29.9%）患者。ASA分级≤3组的不良预后率为3.3%，ASA分级>3组为9.2%（P<0.001）。
本研究的主要发现是ASA分级>3与短期预后不良相关。对于ASA分级>3的患者，建议经验丰富的手术团队在最短时间内进行肺切除，并尽可能保留肺功能。 （备注：原文中CCI有误，应为ASA，译文按照正确的医学术语进行了翻译和修正）
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