Analysis of risk factors of postoperative acute respiratory distress syndrome in patients with esophageal cancer / 肿瘤研究与临床

ABSTRACT

Objective:To investigate the risk factors of postoperative acute respiratory distress syndrome (ARDS) in patients with esophageal cancer.Methods:The clinical data of patients with esophageal cancer who underwent surgery in the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University from January 2020 to April 2021 were retrospectively analyzed, 223 patients were enrolled. The patients were divided into ARDS group (28 cases) and non-ARDS group (195 cases) according to whether ARDS occurred after surgery. The clinicopathological features of the two groups were compared, and the risk factors of postoperative ARDS were analyzed by univariate and multivariate logistic regression.Results:The age of patients in the ARDS group was higher than that in the non-ARDS group [(70±4) years old vs. (66±7) years old, P = 0.024]. The proportion of patients with history of chronic obstructive pulmonary disease (COPD) in the ARDS group was higher than that in the non-ARDS group [25.0% (7/28) vs. 4.6% (9/195), P < 0.001]. There were no statistical differences in gender, systolic pressure, body mass index, left ventricular ejection fraction, laboratory related examinations, history of smoking, history of diabetes, history of hypertension, history of cardiovascular disease, history of cerebrovascular disease, pathological type, tumor location, tumor stage and postoperative complications between the two groups (all P > 0.05). After further adjusting for gender, multivariate logistic regression analysis showed that the old age (≥65 years old) ( OR = 4.581, 95% CI 1.299-16.154, P = 0.018) and the history of COPD ( OR= 5.493, 95% CI 1.644-18.358, P = 0.006) were independent risk factors for postoperative ARDS in patients with esophageal cancer. Conclusions:Esophageal cancer patients with an age of ≥65 years old or history of COPD have a high risk of postoperative ARDS. Age and history of COPD may have certain significances in judging the occurrence of postoperative ARDS in patients with esophageal cancer.