Incidence and Risk Factors of Postoperative Pulmonary Complications in Noncardiac Chinese Patients: A Multicenter Observational Study in University Hospitals
Incidence and Risk Factors of Postoperative Pulmonary Complications in Noncardiac Chinese Patients: A Multicenter Observational Study in University Hospitals
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DOI：
10.1155/2015/265165
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发表时间：
2015-01-01
影响因子：
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通讯作者：
Fang, Xiangming
中科院分区：
文献类型：
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作者：
Jin, Yue;Xie, Guohao;Fang, Xiangming
目的。目的评估我国住院患者术后肺部并发症（PPCs）的发生率，并建立简单的预测风险指数。方法。2012年8月6日至8月12日期间，在四所大学医院接受非心脏手术的患者被纳入研究。该队列分为两个子样本，队列1用于建立PPCs的预测风险指数，队列2用于验证该指数。结果：1673名患者入组。163例（9.7%）患者记录PPCs，其中住院时间（LOS）较长（P < 0.001）。PPCs患者的死亡率为1.84%，无PPCs患者的死亡率为0.07%。队列1的Logistic回归模型确定了9个独立危险因素，包括吸烟、上个月呼吸道感染、术前抗生素使用、术前外周血氧饱和度、手术部位、出血量、术后血糖、白蛋白和通气。该模型在队列2中得到验证，受试者工作特征曲线下面积为0.90 （95% CI 0.86 ~ 0.94）。结论。在中国，PPCs常见于非心脏手术患者，并与延长的LOS相关。本研究建立了风险指数，可用于评估PPCs的个体风险，指导围手术期的个性化呼吸护理。
Purpose. To assess the incidence of postoperative pulmonary complications (PPCs) in Chinese inpatients, and to develop a brief predictive risk index. Methods. Between August 6, 2012, and August 12, 2012, patients undergoing noncardiac operations in four university hospitals were enrolled. The cohort was divided into two subsamples, cohort 1 to develop a predictive risk index of PPCs and cohort 2 to validate it. Results. 1673 patients were enrolled. PPCs were recorded for 163 patients (9.7%), of whom the hospital length of stay (LOS) was longer (P < 0.001). The mortality was 1.84% in patients with PPCs and 0.07% in those without. Logistic Regression modeling in cohort 1 identified nine independent risk factors, including smoking, respiratory infection in the last month, preoperative antibiotic use, preoperative saturation of peripheral oxygen, surgery site, blood lost, postoperative blood glucose, albumin, and ventilation. The model was validated within cohort 2 with an area under the receiver operating characteristic curve of 0.90 (95% CI 0.86 to 0.94). Conclusions. PPCs are common in noncardiac surgical patients and are associated with prolonged LOS in China. The current study developed a risk index, which can be used to assess individual risk of PPCs and guide individualized perioperative respiratory care.