老年肺癌病人术前衰弱状况与术后并发症的相关性研究

Correlation between preoperative frailty and postoperative complications in elderly patients with lung cancer

目的:探讨老年肺癌病人术前衰弱状况与术后并发症的相关性。方法:采用便利抽样法抽取2019年8月—2020年12月在广西医科大学附属肿瘤医院择期进行胸腔镜肺癌手术治疗的176例老年病人为研究对象,采用一般资料调查表、中文版格列宁根衰弱指标、美国麻醉医师协会(ASA)分级对病人进行调查及评估,观察并记录病人术后并发症发生情况。结果:176例老年肺癌病人中,有58例病人存在衰弱状态,衰弱组与非衰弱组老年肺癌病人术后总并发症发生率比较,差异有统计学意义(χ^(2)=39.420,P<0.001)。二元Logistic回归分析结果显示,术前衰弱是术后总并发症发生的独立危险因素[OR=6.255,95%CI(2.848,13.738)],衰弱评估联合ASA分级预测老年肺癌病人术后并发症发生情况的受试者工作特征曲线下面积(AUC)为0.806(0.739,0.861)。结论:术前衰弱状态是老年肺癌病人术后并发症发生的预测因子,术前衰弱评估可以提高ASA分级对老年肺癌病人术后总并发症发生情况的预测效能。

Objective:To explore correlation between preoperative frailty and postoperative complications in elderly patients with lung cancer.Methods:176 elderly patients underwent elective thoracoscopic lung cancer surgery in Guangxi Medical University Affiliated Cancer Hospital from August 2019 to December 2020 were selected as subjects by convenience sampling.General information questionnaire,Chinese Version Groningen Frailty Indicator and American Society of Anesthesiologists(ASA)classification were used to investigate and evaluate patients,and postoperative complications were observed and recorded.Results:Among 176 elderly patients with lung cancer,58 patients had frail state.There was a significant difference in incidence of total postoperative complications in elderly patients with lung cancer between frail group and non-frail group(χ^(2)=39.420,P<0.001).Binary Logistic regression analysis showed that preoperative frailty was an independent risk factor for total postoperative complications[OR=6.255,95%CI(2.848,13.738)].The area under the receiver operating characteristic curve(AUC)of frailty assessment combined with ASA classification predicted postoperative complications in elderly lung cancer patients was 0.806(0.739,0.861).Conclusions:Preoperative frailty is predictor of postoperative complications in elderly patients with lung cancer.Preoperative frailty assessment can improve predictive power of ASA classification for total postoperative complications in elderly patients with lung cancer.