手术阿普加评分可预测肺癌患者术后并发症和生存情况。

The surgical Apgar score predicts postoperative complications and the survival in lung cancer patients.

机构信息

Department of Thoracic Surgery, Kansai Medical University, 2-5-1 Shinmachi Hirakata-Shi, Osaka, 573-1191, Japan.

Department of Anesthesiology, Kansai Medical University, 2-5-1 Shinmachi Hirakata-Shi, Osaka, 573-1191, Japan.

出版信息

Surg Today. 2023 Sep;53(9):1019-1027. doi: 10.1007/s00595-023-02677-x. Epub 2023 Mar 24.

DOI:10.1007/s00595-023-02677-x

PMID:36961607

Abstract

PURPOSE

The surgical Apgar score (SAS)-calculated using the intraoperative variables estimated blood loss, lowest heart rate, and lowest mean systolic pressure-is associated with mortality in cancer surgery. We investigated the utility of the SAS in patients with lung cancer undergoing surgery.

METHODS

We retrospectively analyzed the data of 691 patients who underwent surgery for primary lung cancer between 2015 and 2019 in a single institute and analyzed the impact of the SAS.

RESULTS

Of the 691 patients, 138 (20%), 57 (8.2%), and 7 (1.0%) had postoperative complications of all grades, grades ≥ III, and grade V, respectively, according to the Clavien-Dindo classification. The C-index for postoperative complications of grades ≥ III was 0.605. A lower score (0-5 points) (odds ratio 3.09 against 8-10 points, P = 0.04) and a lower percentage of vital capacity (odds ratio 0.97, P = 0.04) were independent negative risk factors for major postoperative complications. Patients with a lower score (0-5 points) had poor 5-year overall and cancer-specific survival rates (60.1% and 72.3%, respectively; P < 0.05 for both).

CONCLUSIONS

The surgical Apgar score predicted postoperative complications and the long-term survival. Surgeons may improve surgical results using the SAS.

摘要

目的

手术 Apgar 评分（SAS）——通过术中变量估计失血量、最低心率和最低平均收缩压计算得出——与癌症手术的死亡率相关。我们研究了 SAS 在接受肺癌手术的患者中的应用。

方法

我们回顾性分析了 2015 年至 2019 年间在一家医院接受原发性肺癌手术的 691 例患者的数据，并分析了 SAS 的影响。

结果

根据 Clavien-Dindo 分类，691 例患者中，分别有 138 例（20%）、57 例（8.2%）和 7 例（1.0%）出现了所有等级、等级≥III 级和 V 级的术后并发症。术后并发症等级≥III 级的 C 指数为 0.605。评分较低（0-5 分）（与 8-10 分相比，优势比为 3.09，P=0.04）和肺活量较低（优势比 0.97，P=0.04）是重大术后并发症的独立负风险因素。评分较低（0-5 分）的患者 5 年总生存率和癌症特异性生存率均较差（分别为 60.1%和 72.3%；两者均 P<0.05）。