风险因素分析和预测模型开发,用于胸腔镜肺切除后的空气泄漏
Jiekun Qian1,2, Feilong Guo1,3, Maohui Chen1,3
1Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Journal of thoracic disease
|November 18, 2024
概括
肺切除后的术后空气泄漏 (AL) 是常见的. 一个新的预测模型识别了AL的风险因素,有助于选择无管手术的患者.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
- 外科手术的结果
背景情况:
- 肺切除是一种常见的手术,主要并发症的发生率很低.
- 手术后的空气泄漏 (AL) 仍然是胸腔镜肺切除后的常见并发症.
- 识别AL的风险因素对于优化患者管理和探索替代性手术策略至关重要.
研究的目的:
- 为了确定与胸腔镜肺切除后术后空气泄漏 (AL) 相关的独立风险因素.
- 开发和验证AL的预测模型,以确定适合无管手术的患者.
- 为了提高患者对最小侵入性胸部手术技术的选择.
主要方法:
- 对2,503名接受胸腔镜肺切除的患者的回顾性分析 (2015年1月 - 2020年12月).
- 单变量和多变量逻辑回归分析以确定AL的风险因素.
- 使用来自两个额外中心的数据对预测模型进行外部验证.
主要成果:
- 关节炎的总发病率为11.35% (284/2,503名患者).
- 关键预测AL的因素包括年龄>70,1秒/强迫生命能力比率 (FEV1%<80%) 的强迫呼吸量减少,结节大小,瘤良性/恶性,以及多叶膜粘附的存在和程度.
- 预测模型表现出强的表现,在开发集中的C指数为0.829,在外部验证集中的C指数为0.833.
结论:
- 开发的AL预测模型是准确的,并且可能具有临床价值.
- 这个模型可以帮助临床医生评估空气泄漏的风险.
- 该模型有助于识别适合无管胸部外科手术的候选人,可能减少住院时间并改善患者康复.
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