Analysis of risk factors associated with postoperative lower respiratory infections in the elderly patients with lung carcinoma / 国际肿瘤学杂志

ABSTRACT

Objective To explore the possible risk factors associated with postoperative lower respiratory infections in the elderly patients with lung carcinoma,and to formulate the appropriate preventive strategies according to the results of the study.Methods From January 2014 to April 2015,182 elderly patients with lung carcinoma who were undergoing surgical treatment in Renji Hospital of Shanghai Jiaotong University were collected.All patients were divided into infection group (n =29) and control group (n =153) according to whether occuring postoperative lower respiratory infections or not.The possible risk factors associated with postoperative lower respiratory infections were analyzed by single factor analysis and multivariable Logistic regression model.Results Single factor analysis showed that the postoperative lower respiratory infections of elderly patients with lung carcinoma were associated with age (t =-3.03,P ＜ 0.05),smoking (x2 =5.69,P =0.02),albumin (t =2.40,P =0.02),forced expiratory volume (FEV) 1.0％ (t =5.85,P ＜ 0.05),lung carcinoma stage (x2 =7.06,P =0.01),small cell lung cancer (x2 =5.09,P =0.02),complication with chronic obstructive pulmonary disease (COPD) (x2 =16.28,P ＜0.01) and complication with coronary heart disease (x2 =10.13,P ＜ 0.01).Multivariable Logistic regression analysis showed that age (OR =1.34,95％CI1.13-1.59,x2 =11.17,P＜0.01),smoking (OR=12.68,95％ CI2.06-78.04,x2 =7.50,P=0.01),FEV1.0％ (OR =0.90,95％ CI0.83-0.97,x2 =7.76,P =0.01),squamous-cell carcinoma (OR =6.88,95％ CI1.41-33.56,x2 =5.70,P =0.02),complication with COPD (OR =12.44,95％ CI1.41-109.90,x2 =5.15,P =0.02) and complication with coronary heart disease (OR =10.61,95％ CI2.25-90.50,x2 =7.18,P =0.01) were independent risk factors for postoperative lower respiratory infections in the elderly patients with lung carcinoma.Conclusion Age,smoking,squamous-cell carcinoma,low value of FEV1.0％,complication with COPD or coronary heart disease can increase the risk of postoperative lower respiratory infections in the elderly patients with lung carcinoma.Comprehensive and effective preventive strategies should be performed to reduce the risk of postoperative respiratory infections.