| Objective： Cardiopulmonary exercise test (CPET) was combined with clinical indicators to evaluate the influencing factors of pulmonary complications (PPCs) after thoracoscopic surgery in patients with lung cancer. Methods： Retrospective analysis was performed on the information of patients with lung cancer who underwent video-assisted thoracic surgery (VATS) pneumonectomy in the thoracic surgery department. The baseline data, CPET and clinically relevant data of patients were collected, and the influencing factors of PPCs were found through unifactorial analysis, Logistics multi-factor analysis and receiver operating characteristic curve (ROC), and quantified and verified. Results： A total of 95 patients were included, including 30 patients in the complication group (31.6%) and 65 patients in the non-complication group (68.4%). Univariate analysis results showed that PPCs were significantly correlated with age of >62 years old, intraoperative blood loss of >100 mL, coronary heart disease work, peak VO2, peak VO2%pred, peak VO2/Kg, VE/VCO2 slope, peak VO2/HR, peak VO2/HR%pred (all P<0.05). Patients in the complication group had significantly longer postoperative hospital stay （>10 days） than that in the non-complication group. Multivariate analysis results showed: age >62 years old, bady mass index （BMI）<22.5 kg/m2, blood loss >100 mL and peak VO2/HR%pred were independent influencing factors of PPCs in VATS pneumonectomy, while the other factors had no statistical significance. The ROC curve analysis of the influencing factors of PPCs showed that the area under the ROC curve (AUC) was 0.836, the sensitivity and specificity of PPCs prediction were 93.33% and 63.08%, respectively (95%CI:0.746-0.904).Conclusions： Age>62, BMI<22.5 kg/m2, blood loss >100 mL and peak VO2/HR%pred, as independent influencing factors for the occurrence of PPCs, can well predict the occurrence of PPCs, and higher BMI may be a protective factor for the occurrence of PPCs. |
