Preoperative FeNO as a screening indicator of pulmonary complications after abdominal surgery in patients over 60 years old
Preoperative FeNO as a screening indicator of pulmonary complications after abdominal surgery in patients over 60 years old
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术前FeNO作为60岁以上患者腹部手术后肺部并发症的筛查指标
DOI：
10.1088/1752-7155/9/3/036004
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发表时间：
2015-05
影响因子：
3.8
通讯作者：
Li Enyou
中科院分区：
文献类型：
--
作者：
Pi Xin;Wang Changsong;Li Yue;Zheng Juanjuan;Cui Yinghua;Guo Lei;Lin Ziwei;Zhang Xin;Li Enyou
腹部手术后肺部并发症的发生率高于心脏并发症。目前用于评估术后肺部并发症（PPC）风险的围手术期因素是不完善的。FeNO是与气道炎症反应和支气管高反应性相关的呼吸系统疾病的标志物，可能成为筛选PPC的新指标。选择162例60岁以上拟行全身麻醉下腹部大手术的患者，测定其术前FeNO水平。采用受试者工作特征（ROC）和一般线性回归分析FeNO与PPC等参数的关系。术前FeNO的中位数和四分位数为14.33（9.67-21.10）ppb;几何平均值为14.25 ppb。术前FeNO与年龄相关（P < 0.05），相关系数为0.267。FeNO和PPC的ROC曲线分析得出的概率较高，曲线下面积为0.747（p = 0.001，95%置信区间=0.602-0.893）。临界值为30.2 ppb，敏感性为47.06%，特异性为93.10%。阳性预测值为42.11%，阴性预测值为93.70%。OR值为10.83。PPC组的FeNO幅度大于非PPC组26.20（11.55 - 39.20）vs 13.50（9.55-20.00）; p = 0.008）。术前FeNO水平可用于筛查60岁以上接受腹部手术的患者，FeNO值低于30.2 ppb的PPC发生率较低。
The incidence of pulmonary complications after abdominal surgery is higher than that of cardiac complications. The perioperative factors currently used to assess the risk of postoperative pulmonary complications (PPCs) are imperfect. FeNO is a marker of respiratory system disease related to the airway inflammatory response and bronchial hyperresponsiveness; it may be a new indicator to screen PPCs. A total of 162 patients over 60 years old scheduled for major abdominal surgery under general anesthesia were chosen to measure their preoperative FeNO level. Statistical analyses including the receiver operating characteristic (ROC) and general linear regression were used to analyze the relationships of FeNO with PPCs and other parameters. The medians and quartiles of preoperative FeNO were 14.33 (9.67–21.10) ppb; the geometric mean was 14.25 ppb. Preoperative FeNO correlated to age (P < 0.05), and the coefficient of association was 0.267. ROC curve analysis of FeNO and PPCs resulted in a high probability with an area under the curve of 0.747 (p = 0.001, 95% confidence interval =0.602–0.893). The cut-off level was 30.2 ppb, with 47.06% sensitivity and 93.10% specificity. The positive predictive value of the cut-off was 42.11% and negative predictive value was 93.70%. OR value was 10.83. The magnitude of FeNO in the PPCs group was larger than that in the non-PPCs groups 26.20 (11.55 – 39.20) versus 13.50 (9.55–20.00); p = 0.008). Preoperative FeNO levels may be used to screen the patients over 60 years old undergoing abdominal surgery with a lower probability to suffer PPCs whoes FeNO values less than 30.2 ppb.
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影响因子：
9.8
作者：
N. Marczin;T. Kövesi;D. Royston
通讯作者：
N. Marczin;T. Kövesi;D. Royston
DOI：
10.1183/09031936.93.05060757
发表时间：
1992-06
期刊：
The European respiratory journal
影响因子：
--
作者：
A. Dinh-Xuan
通讯作者：
A. Dinh-Xuan
影响因子：
3.4
作者：
M. Wilkins;L. Zhao;R. Al-Tubuly
通讯作者：
M. Wilkins;L. Zhao;R. Al-Tubuly
DOI：
10.1164/rccm.200408-1069oc
发表时间：
2005-03-01
影响因子：
24.7
作者：
McAlister, FA;Bertsch, K;Jacka, M
通讯作者：
Jacka, M
影响因子：
2.9
作者：
S. Kharitonov
通讯作者：
S. Kharitonov