Correlation of lung ultrasound score with postoperative pulmonary complications in older adults undergoing thoracoscopic lobectomy: a prospective observational study

胸腔镜肺叶切除术老年患者肺部超声评分与术后肺部并发症的相关性:一项前瞻性观察研究

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Abstract

BACKGROUND: It is unclear whether postoperative pulmonary complications (PPC) can be early predicted by lung ultrasound (LUS) score in older adults undergoing thoracoscopic lobectomy. This study aimed to evaluate the validity of lung ultrasound application. METHODS: Two physicians performed lung ultrasonography on patients preoperatively, 30 min postoperatively and 72 h postoperatively to obtain LUS score. Pulmonary complications occurred within 10 days postoperatively were recorded. The correlation between lung ultrasound results and PPC was analyzed using logistic regression model. ROC curve were applied to assess the prediction accuracy. RESULTS: PPC occurred in 115 of 292 patients (39.38%) in this study. Independent risk factors for PPC included higher age (OR 1.16, 95% CI 1.04-1.29, p = 0.007), COPD comorbidity (OR 5.03, 95% CI 1.29-19.59, p = 0.020), lower preoperative hemoglobin level (OR 0.96, 95% CI 0.93-1.00, p = 0.043), and higher postoperative 30 min LUS score (OR 1.32, 95% CI 1.22-1.43, p < 0.001). Postoperative 30 min lung ultrasound score (AUC: 0.811, cut-off: 14) shown in the ROC curve analysis was effective in predicting postoperative outcomes. CONCLUSIONS: Postoperative 30 min lung ultrasound score is a risk factor for PPC in older adults undergoing thoracoscopic lobectomy in this study. The value of lung ultrasound as a predictive tool for PPC is warranted. TRIAL REGISTRY: This study was registered in China Clinical Trial Registry (ChiCTR2100053449).

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