Risk stratification of postoperative pulmonary complications in elderly patients undergoing lung cancer resection: a propensity score-matched study

作者：Qiubo Huang, Ritika Rauniyar, Yang Jiao, Chen Zhou, Dezhong Cai, Toyofumi F. Chen‐Yoshikawa, Yojiro Yutaka, Riccardo Orlandi, Travis C. Geraci, Jules Lin, Huilian Hu, Ziqi Jiang, Guangqiang Zhao, Lianhua Ye · 发表于：Journal of Thoracic Disease · 年份：2023 · DOI：10.21037/jtd-23-923 · 被引用次数：13 · 研究领域：Lung Cancer Diagnosis and Treatment、Cardiac, Anesthesia and Surgical Outcomes、Enhanced Recovery After Surgery

Background: In China, lung cancer mainly affects the elderly population. Surgery remains the standard treatment for lung cancer in elderly patients, however, postoperative pulmonary complications (PPCs) are major contributors to morbidity and mortality following lung resection. This study aimed to identify perioperative predictors of PPCs among elderly patients undergoing pulmonary resection for lung cancer to provide evidence for better prevention and intervention for PPCs. Methods: A retrospective study was conducted with 456 patients (age >65 years) undergoing pulmonary resection for lung cancer in Yunnan, China from January 2016 to March 2019. Propensity score matching (PSM) was performed to compare preoperative data and clinical characteristics between the PPC and non-PPC groups, followed by binary logistic regression to evaluate predictors of PPCs. Results: Pulmonary complications occurred in 142/456 (31.1%) patients age >65 years, with pneumonia being the most common event (21.7%). Both PSM and binary logistic regression analysis identified American Society of Anesthesiologists (ASA) class <II [odds ratio (OR): 0.177, 95% confidence interval (CI): 0.037-0.854] and video-assisted thoracoscopic surgery (VATS) (OR: 0.576, 95% CI: 0.334-0.992) as protective factors for PPCs. Conclusions: PPCs following lung cancer resection in elderly patients were associated with a higher ASA classification and open thoracotomy. An adequate and comprehensive evaluation of the operative st...