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Combinations of predictors of exercise-induced oxygen desaturation after lung resection: a retrospective
Taizo Goya1, Taro Naka1, Natsuko Takara1
1Department of Rehabilitation, University of the Ryukyus Hospital, Okinawa, Japan.
Background:
Exercise-induced oxygen desaturation (EID) after lung resection can deteriorate the health-related quality of life. Therefore, it is important to identify predictors of EID in order to inform prompt interventions. We aimed to identify the combinations of predictive factors significantly associated with EID after lung resection.
Methods:
This single-center, retrospective, observational study included patients who underwent lung resection for neoplastic lung disease. Patients were divided into the EID [Δ saturation of peripheral oxygen (SpO2) ≥4%] and non-EID (ΔSpO2 <4%) groups based on the ΔSpO2 assessed using the 6-minute walk test at the time of discharge. We performed decision-tree analysis using EID and non-EID as the outcome variables. The area under the curve (AUC) was calculated to evaluate the predictive accuracy of the decision-tree model.
Results:
We included 100 patients in the analysis; among them, 43 [mean 66.1, standard deviation (SD) 9.8 years] and 57 (mean 63.4, SD 14.1 years) were in the EID and non-EID groups, respectively. Decision-tree analysis revealed that the combination of preoperative quadriceps force (QF) <64.7% of body weight, preoperative ΔSpO2 >1.7%, and intraoperative blood loss (IBL) ≥36 mL could predict postoperative EID with an 84% probability. The AUC of the model was 0.82 (95% confidence interval 0.73-0.89).
Conclusions:
Preoperative QF and ΔSpO2, as well as IBL, are crucial predictors of EID following lung resection. Further studies are warranted to verify the diagnostic validity of this predictive model.
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