Significance of Relative Left Ventricle Wall Thickness in Predicting Acute Kidney Injury After Video-Assisted Thoracoscopic Surgery for Lung Cancer.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL British journal of hospital medicine Pub Date : 2024-12-30 Epub Date: 2024-12-23 DOI:10.12968/hmed.2024.0840
Xiaokang Shen, Yue Zhang, Chuanfei Zhan, Muhammad Zunair Bhatti, Hongyu Zhu, Lin Zheng
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Abstract

Aims/Background Given the strong association between relative wall thickness (RWT) and cardiovascular dysfunction, this study aims to explore RWT as a novel cardiovascular indicator to predict the risk of acute kidney injury (AKI) after lung cancer surgery and guide clinical interventions. Methods This study retrospectively analyzed 170 patients who underwent video-assisted thoracoscopic surgery (VATS) for lung cancer in Nanjing First Hospital, China, between January 2022 and December 2023. Patients were divided into AKI group (n = 52) and non-AKI group (n = 118) based on the occurrence of AKI. Univariate analysis was performed to identify factors affecting the development of AKI in patients undergoing VATS for lung cancer. Moreover, multivariate logistic regression analysis was conducted to determine influencing factors. Correlation analysis was used to analyze the relationships between variables, and receiver operating characteristic (ROC) curve analysis was conducted to assess predictive ability. Results There were no statistically significant differences in gender, comorbidities, smoking history, tumor location, Tumor-Node-Metastasis (TNM) Staging System, tumor differentiation, neutrophil count, red blood cell count, white blood cell count, creatinine, urea nitrogen, intraoperative blood loss, and operation time (p > 0.05). The comparison of age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, mean arterial pressure, and RWT between the two groups showed statistically significant differences (p < 0.05). Multivariate logistic regression analysis indicated that age, APACHE II score, mean arterial pressure, and RWT significantly influenced the development of AKI in patients undergoing VATS for lung cancer (p < 0.05). RWT was negatively correlated with mean arterial pressure (r = -0.558, p < 0.05), and positively correlated with age and APACHE II Score (r = 0.573, 0.520, p < 0.05). Moreover, AKI showed a positive correlation with age, APACHE II Score, and RWT (r = 0.726, 0.685, 0.772, p < 0.05), and a negative correlation with mean arterial pressure (r = -0.724, p < 0.05). ROC analysis revealed that the area under the predicted curve for RWT was 0.864, and the standard error was 0.030 (95% confidence interval (CI): 0.805~0.923), with a Youden index of 0.55. At this time, the sensitivity was 87.29% and the specificity was 67.31%. Conclusion RWT shows excellent predictive value for postoperative AKI in patients undergoing VATS for lung cancer.

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相对左心室壁厚度在预测肺癌胸腔镜手术后急性肾损伤中的意义。
目的/背景鉴于相对壁厚(RWT)与心血管功能障碍之间存在较强的相关性,本研究旨在探讨RWT作为预测肺癌术后急性肾损伤(AKI)风险并指导临床干预的一种新的心血管指标。方法回顾性分析2022年1月至2023年12月在中国南京第一医院接受视频胸腔镜手术(VATS)治疗肺癌的170例患者。根据AKI发生情况将患者分为AKI组(n = 52)和非AKI组(n = 118)。进行单因素分析以确定影响肺癌VATS患者AKI发展的因素。并进行多因素logistic回归分析,确定影响因素。采用相关分析分析变量之间的关系,采用受试者工作特征(ROC)曲线分析评价预测能力。结果两组患者在性别、合并症、吸烟史、肿瘤部位、肿瘤-淋巴结-转移(TNM)分期、肿瘤分化、中性粒细胞计数、红细胞计数、白细胞计数、肌酐、尿素氮、术中出血量、手术时间等方面差异无统计学意义(p < 0.05)。两组患者年龄、急性生理与慢性健康评估(APACHE II)评分、平均动脉压、RWT比较,差异均有统计学意义(p < 0.05)。多因素logistic回归分析显示,年龄、APACHEⅱ评分、平均动脉压、RWT显著影响肺癌VATS患者AKI的发生(p < 0.05)。RWT与平均动脉压呈负相关(r = -0.558, p < 0.05),与年龄、APACHEⅱ评分呈正相关(r = 0.573, 0.520, p < 0.05)。AKI与年龄、APACHEⅱ评分、RWT呈正相关(r = 0.726、0.685、0.772,p < 0.05),与平均动脉压呈负相关(r = -0.724, p < 0.05)。ROC分析显示,RWT预测曲线下面积为0.864,标准误差为0.030(95%可信区间(CI): 0.805~0.923),约登指数为0.55。此时的敏感性为87.29%,特异性为67.31%。结论RWT对肺癌VATS患者术后AKI有较好的预测价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
British journal of hospital medicine
British journal of hospital medicine 医学-医学:内科
CiteScore
1.50
自引率
0.00%
发文量
176
审稿时长
4-8 weeks
期刊介绍: British Journal of Hospital Medicine was established in 1966, and is still true to its origins: a monthly, peer-reviewed, multidisciplinary review journal for hospital doctors and doctors in training. The journal publishes an authoritative mix of clinical reviews, education and training updates, quality improvement projects and case reports, and book reviews from recognized leaders in the profession. The Core Training for Doctors section provides clinical information in an easily accessible format for doctors in training. British Journal of Hospital Medicine is an invaluable resource for hospital doctors at all stages of their career. The journal is indexed on Medline, CINAHL, the Sociedad Iberoamericana de Información Científica and Scopus.
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