Zhang Zhe, Wang Tianpeng, Liu Feng, Xiao Dawang, Yu Guangqun, Jia Zhongfeng, Yang Rong, Zhang Wenwen, Bai Jing
Department of Breast Surgery, Fuyang Cancer Hospital, Fuyang, Anhui Province, China.
Medicine (Baltimore). 2025 Jul 4;104(27):e43037. doi: 10.1097/MD.0000000000043037.
Breast cancer, the most common malignancy in women, often requires modified radical mastectomy, which can lead to complications like postoperative pulmonary infections. These infections, with an incidence of 11.26 to 20.19%, significantly impact prognosis and mortality. Frailty and nutritional status (Controlling Nutritional Status [CONUT] score) are key predictors of these complications, highlighting the need for their early assessment. This study assesses the predictive value of preoperative frailty combined with the CONUT score for postoperative pulmonary infections in breast cancer patients. Patients who underwent elective modified radical mastectomy for breast cancer at Fuyang Cancer Hospital between January 2022 to February 2024 were included. Frailty and nutritional status were evaluated within 24 hours of admission using the frailty scale and CONUT score, respectively. Multivariable logistic regression was employed to identify independent risk factors for postoperative pulmonary infections. The predictive performance of the combined frailty and CONUT score was assessed using receiver operating characteristic curves and decision curve analysis. A total of 416 patients were analyzed, with 84 exhibiting preoperative frailty and 39 experiencing postoperative pulmonary infections. Preoperative frailty, CONUT score, age, and a history of combined chemoradiotherapy were identified as independent risk factors for postoperative pulmonary infections. The combined assessment of preoperative frailty and CONUT score demonstrated strong predictive value, with an area under the curve of 0.777 (95% confidence interval: 0.700-0.854). The combination of preoperative frailty and the CONUT score is an effective tool for predicting postoperative pulmonary infections in breast cancer patients.
乳腺癌是女性中最常见的恶性肿瘤,通常需要进行改良根治性乳房切除术,这可能导致术后肺部感染等并发症。这些感染的发生率为11.26%至20.19%,对预后和死亡率有显著影响。虚弱和营养状况(控制营养状况[CONUT]评分)是这些并发症的关键预测因素,凸显了早期评估的必要性。本研究评估术前虚弱与CONUT评分相结合对乳腺癌患者术后肺部感染的预测价值。纳入了2022年1月至2024年2月期间在阜阳肿瘤医院接受择期改良根治性乳房切除术的乳腺癌患者。分别在入院后24小时内使用虚弱量表和CONUT评分评估虚弱和营养状况。采用多变量逻辑回归来确定术后肺部感染的独立危险因素。使用受试者工作特征曲线和决策曲线分析评估联合虚弱和CONUT评分的预测性能。共分析了416例患者,其中84例术前虚弱,39例术后发生肺部感染。术前虚弱、CONUT评分、年龄和放化疗联合史被确定为术后肺部感染的独立危险因素。术前虚弱和CONUT评分的联合评估显示出较强的预测价值,曲线下面积为0.777(95%置信区间:0.700 - 0.854)。术前虚弱与CONUT评分的组合是预测乳腺癌患者术后肺部感染的有效工具。