PDF(Pubmed)
Abstract：
UNASSIGNED: A series of complications will inevitably occur after thoracoscopic pulmonary resection. How to avoid or reduce postoperative complications is an important research area in the perioperative treatment of thoracic surgery. This study analyzed the risk factors for thoracoscopic postoperative complications of non-small cell lung cancer (NSCLC) and established a nomogram prediction model in order to provide help for clinical decision-making.
UNASSIGNED: Patients with NSCLC who underwent thoracoscopic surgery from January 2017 to December 2021 were selected as study subjects. The relationship between patient characteristics, surgical factors, and postoperative complications was collected and analyzed. Based on the results of the statistical regression analysis, a nomogram model was constructed, and the predictive performance of the nomogram model was evaluated.
UNASSIGNED: A total of 872 patients who met the study criteria were included in the study. A total of 171 patients had complications after thoracoscopic surgery, accounting for 19.6% of the study population. Logistic regression analysis showed that thoracic adhesion, history of respiratory disease, and lymphocyte-monocyte ratio (LMR) were independent risk factors for complications after thoracoscopic surgery (P<0.05). Variables with P<0.1 in logistic regression analysis were included in the nomogram model. The verification results showed that the area under curve (AUC) of the model was 0.734 [95% confidence interval (CI): 0.693-0.775], and the calibration curve showed that the model had good differentiation. The decision curve analysis (DCA) curve showed that this model has good clinical application value. In subgroup analysis of complications, gender, history of respiratory disease, body mass index (BMI), type of surgical procedure, thoracic adhesion, and Time of operation were identified as significant risk factors for prolonged air leak (PAL) after surgery. Tumor location and forced expiratory volume in the first second (FEV1) were identified as important risk factors for postoperative pulmonary infection. N stage and thoracic adhesion were identified as significant risk factors for postoperative pleural effusion. The AUC for PAL was 0.823 (95% CI: 0.768-0.879). The AUC of postoperative pulmonary infection was 0.714 (95% CI: 0.627-0.801). The AUC of postoperative pleural effusion was 0.757 (95% CI: 0.650-0.864). The calibration curve and DCA curve indicated that the model had good predictive performance and clinical application value.
UNASSIGNED: This study analyzed the risk factors affecting the postoperative complications of NSCLC through thoracoscopic surgery, and the nomogram model built based on the influencing factors has certain significance for the identification and reduction of postoperative complications.
UNASSIGNED: Patients with NSCLC who underwent thoracoscopic surgery from January 2017 to December 2021 were selected as study subjects. The relationship between patient characteristics, surgical factors, and postoperative complications was collected and analyzed. Based on the results of the statistical regression analysis, a nomogram model was constructed, and the predictive performance of the nomogram model was evaluated.
UNASSIGNED: A total of 872 patients who met the study criteria were included in the study. A total of 171 patients had complications after thoracoscopic surgery, accounting for 19.6% of the study population. Logistic regression analysis showed that thoracic adhesion, history of respiratory disease, and lymphocyte-monocyte ratio (LMR) were independent risk factors for complications after thoracoscopic surgery (P<0.05). Variables with P<0.1 in logistic regression analysis were included in the nomogram model. The verification results showed that the area under curve (AUC) of the model was 0.734 [95% confidence interval (CI): 0.693-0.775], and the calibration curve showed that the model had good differentiation. The decision curve analysis (DCA) curve showed that this model has good clinical application value. In subgroup analysis of complications, gender, history of respiratory disease, body mass index (BMI), type of surgical procedure, thoracic adhesion, and Time of operation were identified as significant risk factors for prolonged air leak (PAL) after surgery. Tumor location and forced expiratory volume in the first second (FEV1) were identified as important risk factors for postoperative pulmonary infection. N stage and thoracic adhesion were identified as significant risk factors for postoperative pleural effusion. The AUC for PAL was 0.823 (95% CI: 0.768-0.879). The AUC of postoperative pulmonary infection was 0.714 (95% CI: 0.627-0.801). The AUC of postoperative pleural effusion was 0.757 (95% CI: 0.650-0.864). The calibration curve and DCA curve indicated that the model had good predictive performance and clinical application value.
UNASSIGNED: This study analyzed the risk factors affecting the postoperative complications of NSCLC through thoracoscopic surgery, and the nomogram model built based on the influencing factors has certain significance for the identification and reduction of postoperative complications.
摘要：
■胸腔镜肺切除术后不可避免地会发生一系列并发症。如何避免或减少术后并发症是胸外科围手术期治疗的重要研究领域。本研究分析了非小细胞肺癌(NSCLC)胸腔镜术后并发症的危险因素,并建立了列线图预测模型,以期为临床决策提供帮助。
■选择2017年1月至2021年12月接受胸腔镜手术的非小细胞肺癌患者作为研究对象。患者特征之间的关系，手术因素，收集并分析术后并发症。根据统计回归分析的结果，建立了一个列线图模型，并评估了列线图模型的预测性能。
■总共872名符合研究标准的患者被纳入研究。共有171例患者在胸腔镜手术后出现并发症,占研究人群的19.6%。Logistic回归分析显示胸廓粘连,呼吸道疾病史，淋巴细胞-单核细胞比值(LMR)是胸腔镜术后并发症的独立危险因素(P<0.05)。逻辑回归分析中P<0.1的变量包括在列线图模型中。验证结果表明，该模型的曲线下面积（AUC）为0.734[95％置信区间（CI）：0.693-0.775]，校准曲线表明模型具有良好的区分度。决策曲线分析(DCA)曲线表明该模型具有较好的临床应用价值。在并发症的亚组分析中，性别,呼吸道疾病史，体重指数（BMI），外科手术类型,胸部粘连，和手术时间被确定为手术后长期漏气（PAL）的重要危险因素。肿瘤位置和第一秒用力呼气容积（FEV1）被确定为术后肺部感染的重要危险因素。N分期和胸腔粘连是术后胸腔积液的重要危险因素。PAL的AUC为0.823(95%CI:0.768-0.879)。术后肺部感染的AUC为0.714(95%CI:0.627～0.801)。术后胸腔积液的AUC为0.757(95%CI:0.650～0.864)。校准曲线和DCA曲线表明该模型具有良好的预测性能和临床应用价值。
■本研究分析了影响非小细胞肺癌胸腔镜手术术后并发症的危险因素，根据影响因素建立的列线图模型对识别和减少术后并发症具有一定的意义。
■选择2017年1月至2021年12月接受胸腔镜手术的非小细胞肺癌患者作为研究对象。患者特征之间的关系，手术因素，收集并分析术后并发症。根据统计回归分析的结果，建立了一个列线图模型，并评估了列线图模型的预测性能。
■总共872名符合研究标准的患者被纳入研究。共有171例患者在胸腔镜手术后出现并发症,占研究人群的19.6%。Logistic回归分析显示胸廓粘连,呼吸道疾病史，淋巴细胞-单核细胞比值(LMR)是胸腔镜术后并发症的独立危险因素(P<0.05)。逻辑回归分析中P<0.1的变量包括在列线图模型中。验证结果表明，该模型的曲线下面积（AUC）为0.734[95％置信区间（CI）：0.693-0.775]，校准曲线表明模型具有良好的区分度。决策曲线分析(DCA)曲线表明该模型具有较好的临床应用价值。在并发症的亚组分析中，性别,呼吸道疾病史，体重指数（BMI），外科手术类型,胸部粘连，和手术时间被确定为手术后长期漏气（PAL）的重要危险因素。肿瘤位置和第一秒用力呼气容积（FEV1）被确定为术后肺部感染的重要危险因素。N分期和胸腔粘连是术后胸腔积液的重要危险因素。PAL的AUC为0.823(95%CI:0.768-0.879)。术后肺部感染的AUC为0.714(95%CI:0.627～0.801)。术后胸腔积液的AUC为0.757(95%CI:0.650～0.864)。校准曲线和DCA曲线表明该模型具有良好的预测性能和临床应用价值。
■本研究分析了影响非小细胞肺癌胸腔镜手术术后并发症的危险因素，根据影响因素建立的列线图模型对识别和减少术后并发症具有一定的意义。
