Abstract：
BACKGROUND: To date, surgery is the best approach to maximize a cure for symptomatic aspergilloma, but this is not without risk of both morbidity and mortality. The aim of this study is to present the characteristics and outcomes of 77 patients diagnosed with aspergilloma who underwent surgery at Chiang Mai University Hospital (CMUH), and to identify risk factors for composite major postoperative complications (CMPC).
METHODS: This is an observational retrospective cohort study carried out at CMUH over a period of 11 years from January 1, 2010, to February 28, 2021. Patient characteristics and postoperative outcomes were studied. The primary outcomes were categorized into CMPC. Univariable and multivariable risk regression analysis were used to identify risk factors of CMPC, with risk ratio (RR) and 95% confidence intervals being calculated.
RESULTS: There were 77 patients included in this study; 27 patients identified as having CMPC and 55 patients as a non-CMPC group. From the multivariable analysis, a factor associated with CMPC included perioperative FFP transfusion (risk ratio (RR) 1.01,95 % CI 1.01-1.02) and preoperative angiogram embolization (RR 8.42, 95 % CI 1.44-49.06) whereas immediate extubation (RR 0.22, 95% CI 0.06-0.81) was less likely to be associated with CMPC. There was a trend of increased risk of CMPC in patients received perioperative blood transfusion, but the data did not reach statistical significance.
CONCLUSIONS: This study has identified a need for patient profiling before embarking on lung surgery for aspergilloma, to predict outcomes and allocate resources appropriately for safer surgery.
METHODS: This is an observational retrospective cohort study carried out at CMUH over a period of 11 years from January 1, 2010, to February 28, 2021. Patient characteristics and postoperative outcomes were studied. The primary outcomes were categorized into CMPC. Univariable and multivariable risk regression analysis were used to identify risk factors of CMPC, with risk ratio (RR) and 95% confidence intervals being calculated.
RESULTS: There were 77 patients included in this study; 27 patients identified as having CMPC and 55 patients as a non-CMPC group. From the multivariable analysis, a factor associated with CMPC included perioperative FFP transfusion (risk ratio (RR) 1.01,95 % CI 1.01-1.02) and preoperative angiogram embolization (RR 8.42, 95 % CI 1.44-49.06) whereas immediate extubation (RR 0.22, 95% CI 0.06-0.81) was less likely to be associated with CMPC. There was a trend of increased risk of CMPC in patients received perioperative blood transfusion, but the data did not reach statistical significance.
CONCLUSIONS: This study has identified a need for patient profiling before embarking on lung surgery for aspergilloma, to predict outcomes and allocate resources appropriately for safer surgery.
摘要：
背景：迄今为止，手术是最大限度地治愈症状性曲霉菌的最佳方法，但这并非没有发病率和死亡率的风险。这项研究的目的是介绍在清迈大学医院（CMUH）接受手术的77例被诊断为曲霉菌瘤的患者的特征和结果。并确定复合主要术后并发症（CMPC）的危险因素。
方法：这是一项观察性回顾性队列研究，从2010年1月1日至2021年2月28日，在CMUH进行了11年的时间。研究了患者特征和术后结果。主要结果分为CMPC。单变量和多变量风险回归分析用于识别CMPC的危险因素。计算风险比(RR)和95%置信区间。
结果：本研究包括77名患者；27名患者被确定为患有CMPC，55名患者为非CMPC组。从多变量分析来看，与CMPC相关的因素包括围手术期FFP输血(风险比(RR)1.01,95%CI1.01-1.02)和术前血管造影栓塞(RR8.42,95%CI1.44-49.06),而即刻拔管(RR0.22,95%CI0.06-0.81)与CMPC相关的可能性较小.围手术期输血患者发生CMPC的风险有增加的趋势,但数据没有达到统计学意义。
结论：这项研究确定了在开始肺曲菌瘤手术之前需要对患者进行分析，预测结果并为更安全的手术适当分配资源。
方法：这是一项观察性回顾性队列研究，从2010年1月1日至2021年2月28日，在CMUH进行了11年的时间。研究了患者特征和术后结果。主要结果分为CMPC。单变量和多变量风险回归分析用于识别CMPC的危险因素。计算风险比(RR)和95%置信区间。
结果：本研究包括77名患者；27名患者被确定为患有CMPC，55名患者为非CMPC组。从多变量分析来看，与CMPC相关的因素包括围手术期FFP输血(风险比(RR)1.01,95%CI1.01-1.02)和术前血管造影栓塞(RR8.42,95%CI1.44-49.06),而即刻拔管(RR0.22,95%CI0.06-0.81)与CMPC相关的可能性较小.围手术期输血患者发生CMPC的风险有增加的趋势,但数据没有达到统计学意义。
结论：这项研究确定了在开始肺曲菌瘤手术之前需要对患者进行分析，预测结果并为更安全的手术适当分配资源。
