老年胃癌患者术后严重并发症多因素Logistic回归分析

Logistic regression analysis of independent risk factors affecting post-operative severe complications inelderly patents with gastric cancer

【摘要】目的探讨老年患者胃癌切除术后严重并发症的主要危险因素。方法对2006年1月至2011年6月236例老年患者胃癌切除术后的临床资料进行回顾性分析，用Logistic回归分析研究术后严重并发症的相关因素。结果老年胃癌患者术后无和有并发症组年龄[（72．9±5．8）、（80．6±6．7），t=9．194、P=0．0003岁、血红蛋白[（109．94±18．72）、（98．75±18．82），t=4．391、P=0．000]g／L血清白蛋白[（38．37±5．52）、（33．69±3．35），t=7．080、P=0．000]g／L、手术时间[（3．1±1．0）、（3．6±1．1），t=3．507、P=0．001]h、术中输血量[（2．5±4．4）、（2．8土5．5），t=4．901、P=0．0003L、肿瘤长径[（4．5±2．8）、（5．3±2．7），t=-2．111、P=0．0363cm。老年胃癌患者术后严重并发症与慢性阻塞性肺疾病、血清白蛋白水平、年龄、手术时间及术中补液量有关，预测模型为：P=1／[1＋e^（16.22-033×1＋0.99×3-3.90×4-1.92×5-4.93×9）]。结论慢性阻塞性肺疾病、手术时间、术中补液量、血清白蛋白水平及年龄是老年胃癌患者术后严重并发症的独立危险因素。

Objective To explore main risk factors of post-operative severe complications in elderly patients with gastric cancer. Methods From January 2006 to June 2011, a total of 236 elderly patients to receive gastrectomy for gastric carcinoma were retrospectively analyzed in this case- control study. The factors affecting post-operative severe complications were analyzed by multivariate logistic regression analysis. Results Age was younger in patients without than those with post- operative complications [（72.9±5.8） years vs. （80.6±6.7） years, t=-9.194, P=0. 000]. Serum levels of hemoglobin and albumin were higher in patients without than with post-operative complications （（109.94±18.72） g/L vs. （98.75± 18.82） g/L, （38.37±5.52） g/L vs. （33.69± 3.35） g/L, t=4. 391, 7. 080, both P=0. 0003. Operation time was shorter in patients without than with post-operative complications [（3.1 ± 1.0） hours vs. （3.6 ± 1.1） hours, t = - 3. 507, P = 0. 001 ）3. Intraoperative blood transfusion volume was less in patients without than with post-operative complications （（2.5±4.4） L vs. （2.84-5.5） L, t=-4.901, P=0.000）3. The long diameter of tumor was shorter in patients without than with post-operative complications （（4.5 ± 2.8） cm vs. （5.3± 2.7） cm, t = - 2. 111, P = 0. 036）3 . Logistic regression analysis revealed that chronic obstructive pulmonary disease （COPD）, serum albumin level, age, operation time and blood transfusion volume were associated with postoperative severe complications. Logistic regression equation was as follow： P= 1/[1＋e（16. 22-033×1＋0.99×3 3.90×4-1.92×5 4.93×9） 3. Conclusions COPD, operation time, blood transfusion volume, serum albumin level and age are the main independent risk factors for post-operative severe complications in elderly patients with gastric cancer.