Baar Wolfgang, Semmelmann Axel, Anselm Florian, Loop Torsten, Heinrich Sebastian
Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.
German Society of Anesthesiology and Intensive Care Medicine, 10115 Nürnberg, Germany.
J Clin Med. 2025 Feb 26;14(5):1565. doi: 10.3390/jcm14051565.
Postoperative pulmonary complications (PPCs) are the most common complications following lung surgery and can lead to increased postoperative mortality. In this study, we examined the incidence of PPCs, the in-hospital mortality rate, and the risk factors associated with PPCs in patients undergoing open thoracotomy lung resection (OTLR) for reasons other than primary lung cancer. : Data from this multicenter, retrospective study involving 1.368 patients were extracted from the German Thorax Registry and analyzed using univariate and multivariable statistical methods. : In total, 278 patients showed at least one PPC. The presence of PPCs was associated with a significantly higher in-hospital mortality rate (7.2% vs. 1.5%; = 0.000). Multivariable stepwise logistic regression analysis showed absolute age (OR 1.02) and BMI ≤ 19 (OR 2.6) as independent patient-specific risk factors. Significant preoperative risk factors included re-thoracotomy (OR 4.0) and FEV < 60% (OR 2.5). Procedure-related independent risk factors for PPCs included a surgical duration surpassing 195 min (OR 2.7), the continuation of invasive ventilation post-surgery (OR 3.8), and an intraoperative infusion of crystalloids greater than 6 mL/kg/h (OR 1.8). : Optimizing intraoperative fluid therapy and on-table extubation when possible may reduce the incidence of PPCs and associated mortality.
术后肺部并发症（PPCs）是肺手术后最常见的并发症，可导致术后死亡率增加。在本研究中，我们调查了因非原发性肺癌接受开胸肺切除术（OTLR）患者的PPCs发生率、院内死亡率以及与PPCs相关的危险因素。：本多中心回顾性研究纳入1368例患者的数据，从德国胸部注册中心提取，并采用单因素和多因素统计方法进行分析。：共有278例患者出现至少一种PPCs。PPCs的存在与显著更高的院内死亡率相关（7.2%对1.5%；P = 0.000）。多因素逐步逻辑回归分析显示，绝对年龄（OR 1.02）和BMI≤19（OR 2.6）是独立的患者特异性危险因素。术前显著的危险因素包括再次开胸（OR 4.0）和FEV<60%（OR 2.5）。与手术相关的PPCs独立危险因素包括手术时间超过195分钟（OR 2.7）、术后继续有创通气（OR 3.8）以及术中晶体液输注量大于6 mL/kg/h（OR 1.8）。：优化术中液体治疗并尽可能在手术台上拔管可能会降低PPCs的发生率及相关死亡率。
