Comparison of clinical effects of three criteria for postoperative pulmonary complications / 中华麻醉学杂志

ABSTRACT

Objective:To compare the clinical effects of the three criteria for postoperative pulmonary complications (PPCs).Methods:The clinical data of patients underwent thoracoscopic lung resection between January 2021 and July 2021 in our hospital were retrospectively analyzed.PPCs were assessed using the Melbourne Group Scale (MGS), European Perioperative Clinical Outcome (EPCO) and Standardized Endpoints for Perioperative Medicine (StEP) criteria.The patients were divided into PPC group and non-PPC group according to the above criteria.The diagnostic rates of PPCs of the three criteria were recorded.Cohen′s weighted kappa coefficient was used to evaluate the agreement between the three criteria.Logistic regression method was used to analyze the association between PPCs diagnosed by different criteria and risk of adverse prognostic events developed.Results:A total of 397 patients who underwent thoracoscopic lung surgery were included in this study.The rate of PPCs diagnosed by MGS criterion was significantly lower than those by EPCO and StEP criteria ( P<0.001), and the rate of PPCs diagnosed by EPCO criterion was significantly higher than those by StEP criterion ( P<0.001). The diagnostic agreement between EPCO criterion and StEP criterion was good ( κ=0.624, P<0.001), while the diagnostic agreement between EPCO criterion, StEP criterion and MGS criterion was poor ( κ=0.101, P<0.001; κ=0.210, P<0.001). Univariate and multivariate logistic regression analysis showed that PPCs diagnosed by EPCO and StEP criteria increased the risk of adverse prognostic events developed ( P<0.001). Conclusions:The EPCO and StEP criteria are superior to MGS criterion with regard to the diagnostic and prognostic value for pulmonary complications following thoracoscopic lung resection, and the EPCO criterion had a higher sensitivity.