摘要
目的探讨老年肺癌患者胸腔镜切除术后发生心房颤动(AF)的影响因素,并构建相应的风险预测模型。方法回顾性分析2022年7月至2023年12月中国医学科学院肿瘤医院胸外科收治的184例行胸腔镜切除术的老年肺癌患者资料,其中男性94例,女性90例;年龄(65.2±4.2)岁。统计老年肺癌患者胸腔镜切除术后AF的发生情况。采用单因素和多因素logistic回归分析,探讨老年肺癌患者胸腔镜切除术后AF发生的影响因素。根据影响因素构建列线图预测模型,采用受试者工作特征曲线(ROC)评估列线图预测模型的准确性,并进行校准曲线验证。结果老年肺癌患者胸腔镜切除术后AF的发生率为9.2%(17/184)。单因素分析结果显示,性别、心血管病史、术前肺部感染、术后氧分压、创口疼痛评分与老年肺癌患者胸腔镜切除术后AF的发生有关(均P<0.05)。多因素logistic回归分析结果显示,男性、有心血管病史、氧分压低、术前有肺部感染是老年肺癌患者胸腔镜切除术后发生AF的独立危险因素(均P<0.05)。ROC曲线评价预测模型的曲线下面积为0.854,灵敏度为82.6%,特异度为81.5%。Bootstrap法进行内部验证的C指数为0.801,预测模型的校正曲线与理想曲线拟合良好。结论老年肺癌患者胸腔镜切除术后AF的发生率较高,男性、有心血管病史、氧分压低、术前有肺部感染是老年肺癌患者胸腔镜切除术后发生AF的独立危险因素。根据危险因素构建的老年肺癌患者胸腔镜切除术后发生AF的风险预测模型具有较好的预测效能。
Objective To investigate the influencing factors of atrial fibrillation(AF)after thoracoscopic resection in elderly patients with lung cancer and to construct a corresponding risk prediction model.Methods A retrospective analysis was conducted on the data of 184 elderly lung cancer patients whicch iclcde 94 male and 90 demale,the age range is(65.2±4.2)who underwent thoracoscopic resection at the Thoracic Surgery Department of Cancer Hospital,Chinese Academy of Medical Sciences from July 2022 to December 2023.The incidence of AF after thoracoscopic resection in these patients was statistically analyzed.Univariate and multivariate logistic regression analyses were used to explore the influencing factors of AF occurrence after thoracoscopic resection in elderly lung cancer patients.Based on these influencing factors,a nomogram prediction model was constructed,and its accuracy was evaluated using the receiver operating characteristic(ROC)curve,followed by calibration curve validation.Results The incidence of AF after thoracoscopic resection in elderly lung cancer patients was 9.2%(17/184).Univariate analysis showed that gender,history of cardiovascular disease,preoperative pulmonary infection,postoperative oxygen partial pressure,and wound pain score were related to the occurrence of AF after thoracoscopic resection in elderly lung cancer patients(all P<0.05).Multivariate logistic regression analysis showed that male gender,history of cardiovascular disease,low oxygen partial pressure,and preoperative pulmonary infection were independent risk factors for the occurrence of AF after thoracoscopic resection in elderly lung cancer patients(P<0.05).The area under the ROC curve for evaluating the prediction model was 0.854,with a sensitivity of 82.6%and a specificity of 81.5%.Internal validation using the Bootstrap method yielded a C-index of 0.801,and the calibration curve of the prediction model fit well with the ideal curve.Conclusion The incidence of AF after thoracoscopic resection in elderly lung cancer patients is
作者
张娜
谭敏
李玉善
Zhang Na;Tan Min;Li Yushan(Department of Thoracic Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021)
出处
《中国肿瘤临床与康复》
2024年第5期314-321,共8页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
肺肿瘤
胸腔镜切除
老年患者
心房颤动
危险因素
预测模型
Lung neoplasms
Thoracoscopic Resection
Elderly Patients
Atrial Fibrillation
Risk Factors
Prediction Model
