细分切除术后长时间住院的预测因素
Fatemehsadat Pezeshkian1, Rachel Leo1, Miles A McAllister1
1Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Mass.
The Journal of thoracic and cardiovascular surgery
|April 30, 2024
概括
老年患者,肺功能减弱患者和吸烟者在肺部切除术后长期住院的风险更高. 一个新的名图可能有助于预测和管理这些风险,以获得更好的术后护理.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
- 手术瘤学手术瘤学
背景情况:
- 细分切除术是针对小,外围非小细胞肺癌的标准手术程序.
- 优化术后管理对于改善细分切除术后患者的治疗结果至关重要.
研究的目的:
- 为了确定与细分切除术后长时间住院相关的临床因素.
- 开发一种预测工具,用于分层分类延长住院的个体风险.
主要方法:
- 对接受细分切除术的533名患者 (2018年1月 - 2023年5月) 的回顾性分析.
- 多变量逻辑回归用于确定长时间住院 (≥3天) 的预测因素.
- 开发一个名图表来估计长时间住院的个体风险.
主要成果:
- 年龄较大 (>75岁),肺功能下降 (FEV1 <88%) 和吸烟史与长时间住院有显著联系.
- 开发的名图表显示了中度的预测准确性 (AUC=0.66).
- 主要不良事件发生在5.8%的病例中,30天再入院率为5.8%,90天死亡率为<1%.
结论:
- 老年,肺功能下降和吸烟是细分切除术后长时间住院的关键风险因素.
- 开发的诺米图需要外部验证,但有望改善经过细分切除术的患者的术后风险评估.
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