Risk factors and predictive model for pulmonary complications in patients transferred to ICU after hepatectomy

BMC Surgery

Research

HanSheng Liang¹  Yi Feng¹  Bin Wang²  HuiYing Zhao²  JiaWei Shen²  YouZhong An² 

[1] Department of Anaesthesiology and Pain Medicine, Peking University People’s Hospital, No.11 Xizhimen South Street, 100044, Beijing, China;Department of Critical Care Medicine, Peking University People’s Hospital, No.11 Xizhimen South Street, 100044, Beijing, China;

关键词: Risk factor;    Postoperative pulmonary complication;    Nomogram;    Hepatectomy;   

DOI  :  10.1186/s12893-023-02019-1

 received in 2022-06-16, accepted in 2023-04-26,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectivePostoperative pulmonary complications (PPCs) seriously harm the recovery and prognosis of patients undergoing surgery. However, its related risk factors in critical patients after hepatectomy have been rarely reported. This study aimed at analyzing the factors related to PPCs in critical adult patients after hepatectomy and create a nomogram for prediction of the PPCs.Methods503 patients’ data were collected form the Peking University People’s Hospital. Multivariate logistic regression analysis was used to identify independent risk factors to derive the nomogram. Nomogram’s discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was assessed using the Hosmer–Lemeshow goodness-of-fit test and calibration curve.ResultsThe independent risk factor for PPCs are advanced age (odds ratio [OR] = 1.026; P = 0.008), higher body mass index (OR = 1.139; P < 0.001), lower preoperative serum albumin level (OR = 0.961; P = 0.037), and intensive care unit first day infusion volume (OR = 1.152; P = 0.040). And based on this, we created a nomogram to predict the occurrence of PPCs. Upon assessing the nomogram’s predictive ability, the AUC for the model was 0.713( 95% CI: 0.668–0.758, P<0.001). The Hosmer–Lemeshow test (P = 0.590) and calibration curve showed good calibration for the prediction of PPCs.ConclusionsThe prevalence and mortality of postoperative pulmonary complications in critical adult patients after hepatectomy are high. Advanced age, higher body mass index, lower preoperative serum albumin and intensive care unit first day infusion volume were found to be significantly associated with PPCs. And we created a nomogram model which can be used to predict the occurrence of PPCs.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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