Oh Tak Kyu, Song In-Ae, Hwang Insung, Hwang Jung-Won
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
J Thorac Dis. 2023 Mar 31;15(3):1036-1045. doi: 10.21037/jtd-22-1361. Epub 2023 Feb 16.
Severe complications such as acute respiratory distress syndrome or respiratory failure can occur after lung cancer surgery. However, the prevalence and risk factors have not been well identified. The aim of this study was to investigate the prevalence of and risk factors for fatal respiratory events after lung cancer surgery in South Korea.
The National Health Insurance Service database in South Korea was used to extract data of all adult patients who were diagnosed with lung cancer and underwent lung cancer surgery from January 1, 2011, to December 31, 2018, for a population-based cohort study. Diagnosis of acute respiratory distress syndrome or respiratory failure after surgery was defined as postoperative fatal respiratory event.
A total of 60,031 adult patients who received lung cancer surgery were included in the analysis. Among them, 0.5% (285/60,031) experienced fatal respiratory events after the lung cancer surgery. In multivariable logistic regression, some risk factors (older age, male sex, higher Charlson comorbidity index score, underlying severe disability, bilobectomy, pneumonectomy, redo-case, lower case volume, and open thoracotomy) for developing postoperative fatal respiratory events were identified. Moreover, the development of postoperative fatal respiratory events was associated with high in-hospital mortality, 1-year mortality, longer length of hospital stays, and higher total hospitalization costs.
Postoperative fatal respiratory events might worsen the clinical outcomes of lung cancer surgery. The knowledge of potential risk factors related to postoperative fatal respiratory events could enable earlier intervention to reduce the occurrence of these events and improve the postoperative clinical outcome.
肺癌手术后可能会出现急性呼吸窘迫综合征或呼吸衰竭等严重并发症。然而，其发生率和风险因素尚未得到明确界定。本研究旨在调查韩国肺癌手术后致命性呼吸事件的发生率及风险因素。
利用韩国国民健康保险服务数据库，提取2011年1月1日至2018年12月31日期间所有被诊断为肺癌并接受肺癌手术的成年患者的数据，进行一项基于人群的队列研究。术后急性呼吸窘迫综合征或呼吸衰竭的诊断被定义为术后致命性呼吸事件。
共有60,031例接受肺癌手术的成年患者纳入分析。其中，0.5%（285/60,031）在肺癌手术后发生了致命性呼吸事件。在多变量逻辑回归分析中，确定了一些术后发生致命性呼吸事件的风险因素（年龄较大、男性、Charlson合并症指数评分较高、潜在的严重残疾、双叶切除术、全肺切除术、再次手术、病例数较少以及开胸手术）。此外，术后致命性呼吸事件的发生与住院死亡率高、1年死亡率高、住院时间延长以及总住院费用增加有关。
术后致命性呼吸事件可能会使肺癌手术的临床结局恶化。了解与术后致命性呼吸事件相关的潜在风险因素，有助于早期干预，以减少这些事件的发生并改善术后临床结局。
