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术后肺炎的风险因素及对肺癌患者术后预后的影响:一项回顾性研究。

Risk factors for postoperative pneumonia and prognosis in lung cancer patients after surgery: A retrospective study.

机构信息

Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Medicine (Baltimore). 2021 Apr 2;100(13):e25295. doi: 10.1097/MD.0000000000025295.

Abstract

Postoperative pneumonia (POP) is one of the most frequent complications following lung surgery. The aim of this study was to identify the risk factors for developing POP and the prognostic factors in lung cancer patients after lung resection.We performed a retrospective review of 726 patients who underwent surgery for stages I-III lung cancer at a single institution between August 2017 and July 2018 by conducting logistic regression analysis of the risk factors for POP. The Cox risk model was used to analyze the factors influencing the survival of patients with lung cancer.We identified 112 patients with POP. Important risk factors for POP included smoking (odds ratio [OR], 2.672; 95% confidence interval [CI], 1.586-4.503; P < .001), diffusing capacity for carbon monoxide (DLCO) (40-59 vs ≥80%, 4.328; 95% CI, 1.976-9.481; P < .001, <40 vs ≥80%, 4.725; 95% CI, 1.352-16.514; P = .015), and the acute physiology and chronic health evaluation (APACHE) II score (OR, 2.304; 95% CI, 1.382-3.842; P = .001). In the Cox risk model, we observed that age (hazard ratios (HR), 1.633; 95% CI, 1.062-2.513; P = .026), smoking (HR, 1.670; 95% CI, 1.027-2.716; P = .039), POP (HR, 1.637; 95% CI, 1.030-2.600; P = .037), etc were predictor variables for patient survival among the factors examined in this study.The risk factors for POP and the predictive factors affecting overall survival (OS) should be taken into account for effective management of patients with lung cancer undergoing surgery.

摘要

术后肺炎(POP)是肺部手术后最常见的并发症之一。本研究旨在确定肺癌患者肺切除术后发生 POP 的危险因素和预后因素。

我们对 2017 年 8 月至 2018 年 7 月在一家机构接受 I-III 期肺癌手术的 726 例患者进行了回顾性分析,采用逻辑回归分析 POP 的危险因素。采用 Cox 风险模型分析影响肺癌患者生存的因素。

我们确定了 112 例 POP 患者。POP 的重要危险因素包括吸烟(优势比 [OR],2.672;95%置信区间 [CI],1.586-4.503;P<0.001)、一氧化碳弥散量(DLCO)(40-59 与≥80%,4.328;95%CI,1.976-9.481;P<0.001,<40 与≥80%,4.725;95%CI,1.352-16.514;P=0.015)和急性生理学和慢性健康评估(APACHE)II 评分(OR,2.304;95%CI,1.382-3.842;P=0.001)。在 Cox 风险模型中,我们观察到年龄(危险比 [HR],1.633;95%CI,1.062-2.513;P=0.026)、吸烟(HR,1.670;95%CI,1.027-2.716;P=0.039)、POP(HR,1.637;95%CI,1.030-2.600;P=0.037)等因素是本研究中检查的因素中预测患者生存的变量。

对于接受手术治疗的肺癌患者,应考虑 POP 的危险因素和影响总生存期(OS)的预测因素,以便进行有效的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0a8/8021381/e4191042997d/medi-100-e25295-g001.jpg

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