Subasi Mahmut, Duger Mustafa
Department of Thoracic Surgery, Istanbul Medipol University, International Faculty of Medicine, Istanbul, Türkiye.
Department of Respirology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Oct 19;31(4):517-529. doi: 10.5606/tgkdc.dergisi.2023.25399. eCollection 2023 Oct.
In this systematic review and meta-analysis, we aimed to identify recipient-related preoperative risk factors for airway complications following lung transplantation in adults.
Articles published between November 1995 and February 2023 were searched by a thorough exploration of databases. Studies that addressed recipient-related risk factors for airway complications following adult lung transplantation, such as cohorts, case-control, or cross-sectional studies, were included. Fixed-effects or random-effects models were used to calculate the odds ratios (ORs) or mean differences (MDs) with 95% confidence interval (CI).
Twenty-one studies including a total of 38,321 recipients fulfilled the inclusion criteria. Based on the pooled analyses, taller height (MD=5.98, 95% CI: 5.69-6.27, =57.32%), intraoperative mechanical ventilation (OR=1.83, 95% CI: 1.41-2.38, =0%), male sex (OR=1.52, 95% CI: 1.33-1.74, =15.91%), preoperative extracorporeal membrane oxygenation (OR=1.58, 95% CI: 1.1-2.26, =41.47%), and preoperative steroid use (OR=1.21, 95% CI: 1.04-1.41, =0%) elevated the risk of airway complications following lung transplantation.
Taller height, intraoperative mechanical ventilation, male sex, preoperative extracorporeal membrane oxygenation, and preoperative steroid use can increase the risk of airway complications after lung transplantation. Identifying high-risk recipients or riskless situations can support the advancement of selective treatments or prevent the unnecessary avoidance of certain interventions.
在本系统评价和荟萃分析中，我们旨在确定成人肺移植术后气道并发症的受者相关术前危险因素。
通过全面检索数据库，查找1995年11月至2023年2月发表的文章。纳入涉及成人肺移植术后气道并发症受者相关危险因素的研究，如队列研究、病例对照研究或横断面研究。采用固定效应或随机效应模型计算比值比（OR）或均值差（MD）及95%置信区间（CI）。
21项研究共纳入38321名受者，符合纳入标准。基于汇总分析，身高较高（MD = 5.98，95% CI：5.69 - 6.27，I² = 57.32%）、术中机械通气（OR = 1.83，95% CI：1.41 - 2.38，I² = 0%）、男性（OR = 1.52，95% CI：1.33 - 1.74，I² = 15.91%）、术前体外膜肺氧合（OR = 1.58，95% CI：1.1 - 2.26，I² = 41.47%）和术前使用类固醇（OR = 1.21，95% CI：1.04 - 1.41，I² = 0%）会增加肺移植术后气道并发症的风险。
身高较高、术中机械通气、男性、术前体外膜肺氧合和术前使用类固醇会增加肺移植术后气道并发症的风险。识别高危受者或无风险情况有助于推进选择性治疗或避免不必要地规避某些干预措施。
