Waseda Ryuichi, Yamamoto Hiroyuki, Shintani Yasushi, Sato Toshihiko, Suzuki Kenji, Maniwa Yoshimasa, Sato Yukio, Yoshino Ichiro, Chida Masayuki
Japanese Association for Chest Surgery, Kyoto, Japan.
Department of General Thoracic, Breast, and Pediatric Surgery, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, Japan.
Surg Today. 2025 Mar;55(3):393-404. doi: 10.1007/s00595-024-02926-7. Epub 2024 Aug 27.
We aimed to identify preoperative risk factors for secondary spontaneous pneumothorax surgery.
The National Clinical Database of Japan, with six annual datasets from 2014 to 2019, was used. All patients who underwent surgery for secondary spontaneous pneumothorax were included, excluding those < 15 years old and those with incomplete data. The effects of preoperative risk factors were analyzed for operative mortality (mortality during hospitalization or within 30 days, regardless of hospitalization status), 30-day mortality, and postoperative respiratory morbidities.
Of the 18,309 patients enrolled in the study, operative mortality, 30-day mortality, and postoperative respiratory morbidities were observed in 654 (3.6%), 343 (1.9%), and 2258 (12.3%) patients, respectively. Increasing age, male sex, body mass index < 18.5 or > 30, performance status > 2, emergent surgery, interstitial pneumonia, and diabetes in preoperative co-morbidity, tumors, and other diseases in underlying lung disease were significant risk factors for operative mortality. Those for 30-day mortality included autoimmune disease instead of male sex and diabetes, while those for postoperative respiratory morbidities included lymphangiomyomatosis instead of a body mass index > 30.
We identified many preoperative risk factors for operative mortality, 30-day mortality, and postoperative respiratory morbidities in secondary spontaneous pneumothorax surgery. These findings will assist in selecting appropriate surgical candidates.
我们旨在确定继发性自发性气胸手术的术前危险因素。
使用了日本国家临床数据库，其中包含2014年至2019年的六个年度数据集。纳入所有接受继发性自发性气胸手术的患者，排除年龄<15岁和数据不完整的患者。分析术前危险因素对手术死亡率（住院期间或30天内的死亡率，无论住院状态如何）、30天死亡率和术后呼吸系统并发症的影响。
在纳入研究的18309例患者中，分别有654例（3.6%）、343例（1.9%）和2258例（12.3%）患者出现手术死亡率、30天死亡率和术后呼吸系统并发症。年龄增加、男性、体重指数<18.5或>30、体能状态>2、急诊手术、间质性肺炎、术前合并症中的糖尿病、潜在肺部疾病中的肿瘤和其他疾病是手术死亡率的显著危险因素。30天死亡率的危险因素包括自身免疫性疾病而非男性和糖尿病，而术后呼吸系统并发症的危险因素包括淋巴管平滑肌瘤病而非体重指数>30。
我们确定了继发性自发性气胸手术中手术死亡率、30天死亡率和术后呼吸系统并发症的许多术前危险因素。这些发现将有助于选择合适的手术候选人。
