Development of a Predictive Model for Large-Volume Pleural Effusion After Separation Surgery in Patients With Spinal...

Area of Science:

• Oncology
• Thoracic Surgery
• Radiology

Background:

• Spinal metastatic tumors are often treated with separation surgery and radiotherapy.
• Large-volume postoperative pleural effusion (POPE) is a significant complication, delaying treatment and increasing morbidity.
• Early identification of risk factors for POPE is crucial for improving patient prognosis.

Purpose of the Study:

• To identify independent risk factors for large-volume POPE after separation surgery for spinal metastases.
• To develop and validate a predictive model for early identification of patients at high risk for large-volume POPE.

Main Methods:

• Retrospective analysis of 443 patients undergoing separation surgery for spinal metastases.
• High-resolution CT with 3D modeling for accurate pleural effusion volume quantification.
• Multivariate logistic regression analysis to identify risk factors and develop a predictive nomogram.

Main Results:

• Advanced age, increased intraoperative blood loss, and decreased preoperative serum albumin, postoperative serum protein, and hemoglobin were significant risk factors for large-volume POPE.
• The developed nomogram showed high predictive accuracy (AUC 0.953 training, 0.927 testing).
• The nomogram reliably identifies patients at high risk for large-volume POPE.

Conclusions:

• Independent risk factors for large-volume POPE following spinal metastasis surgery were identified.
• The predictive nomogram serves as a practical tool for early risk stratification.
• Timely interventions based on nomogram predictions can reduce POPE, shorten hospitalization, and expedite treatment resumption, improving patient outcomes.