A risk score for predicting postoperative complications in non-intubated thoracic surgery

Journal of Thoracic Disease

article

Lan Lan¹  Long Jiang²  Chongyang Duan⁴  Weixiang Lu²  Canzhou Zhang¹  Yanyi Cen¹  Jianxing He² 

[1] Department of Anesthesiology, The First Affiliated Hospital of Guangzhou Medical University;Department of CardiothoracicSurgery, the First Affiliated Hospital of Guangzhou Medical University;Guangzhou Institute of Respiratory Disease &China State Key Laboratory of Respiratory Disease;Department of Biostatistics, School of Public Health, Southern MedicalUniversity

关键词: Postoperative complication;    risk score;    non-intubated;    video-assisted thoracoscopic surgery (VATS);   

DOI  :  10.21037/jtd-21-636

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: The risk factors for postoperative complications in non-intubated video-assisted thoracoscopic surgery (VATS) have not been observed before. Here to develop a simple risk score to predict the risk of postoperative complications for patients who scheduling non-intubated VATS, which is beneficial to guide the clinical interventions. Methods: A total of 1,837 patients who underwent non-intubated VATS were included from January 2011 to December 2018. A development data set and a validation data set were allocated according to an approximate 3:2 ratio of total cases. The stepwise logistic regression was used to establish a risk score model, and the methods of bootstrap and split-sample were used for validation. Results: Multivariable analysis revealed that the forced expiratory volume in the first second in percent of predicted, the anesthesia method, blood loss, surgical time, and preoperative neutrophil ratio were risk factors for postoperative complications. The risk score was established with these 5 factors, varied from 0 to 53, with the corresponding predicted probability of postoperative complications occurrence ranged from 1% to 92% and was calibrated (Hosmer-Lemeshow χ 2 =6.261; P=0.618). Good discrimination was acquired in the development and validation data sets (C-statistic 0.705 and 0.700). A positive correlation was between the risk score and postoperative complications (P for trend 30 points] were established based on the score distribution of postoperative complications. Conclusions: This simple risk score model based on risk factors of postoperative complications can validly identify the high-risk patients with postoperative complications in the non-intubated VATS, and allow for early interventions.

【 授权许可】

Unknown