肺癌患者术后住院时间延长(>7天)的影响因素分析

Influencing Factors of Prolonged Postoperative Length of Stay(>7 days)in Patients Undergoing Lung Cancer Surgery

目的:调查肺癌患者术后住院时间延长(>7天)的影响因素。方法:分析2017年11月至2020年1月多中心前瞻性队列研究数据库(CN-PRO-Lung1)中421例肺癌手术患者的临床资料。根据术后住院时间将患者分为正常组(≤7天)和延长组(>7天),采用二元Logistic回归确定独立影响因素。结果:男222例,女199例,平均年龄为(55.70±10.38)岁,中位术后住院时间为7天,其中139例(33.0%)患者术后住院时间延长。单因素分析结果显示,性别、年龄、吸烟史、饮酒史、合并症、手术入路、手术方式、淋巴结清扫、术后并发症级别、病理类型、病理分期和医院类型与肺癌患者术后住院时间延长显著相关(均P<0.05)。多因素分析结果显示,肺叶切除、扩大切除、术后并发症≥Ⅰ级和市县级三级医院是肺癌患者术后住院时间延长的独立危险因素(均P<0.001)。结论:肺癌患者术后住院时间延长较常见,其中肺叶切除、扩大切除、术后发生≥Ⅰ级并发症和在市县级三级医院接受治疗的患者更容易发生术后住院时间延长(>7天)。

Objective:To investigate the influencing factors of prolonged postoperative length of stay(PPLS)(>7 days)in patients undergoing lung cancer surgery.Methods:Clinical data of 421 patients undergoing lung cancer surgery in a multicenter prospective cohort study database(CN-PRO-Lung 1)from November 2017 to January 2020 were analyzed.The patients were assigned to the normal group(≤7 days)and the prolonged group(>7 days)according to PPLS.Binary logistic regression was used to identify the independent influencing factors.Results:There were 222 males and 199 females,with an average age of(55.70±10.38)years.The median postoperative length of stay was 7 days and 139(33.0%)patients had PPLS.Univariate analysis showed that gender,age,smoking history,drinking history,comorbidity,surgical approach,surgical type,lymph node dissection,postoperative complication grade,pathological type,pathological stage and hospital type were significantly correlated to PPLS(all P<0.05).Multivariate analysis showed that lobectomy,extended resection,postoperative complication grade≥I and municipal/county tertiary hospital were independent risk factors of PPIS in patients undergoing lung cancer surgery(all P<0.001).Conclusion:PPLS remains common in patients undergoing lung cancer surgery.Among them,patients with lobectomy,extended resection,postoperative complication grade≥I,and those hospitalized in municipal or county tertiary hospitals are more likely to have a PPLS(>7 days).