Construction of a nomogram model for postoperative complications following thoracoscopic lung cancer surgery in elderly patients: a study based on an elderly patient population
摘要
To evaluate the risk variables for postoperative problems in geriatric patients receiving lung cancer surgery and to develop and validate a nomogram model.
Patients and methodsThe relationship between non-small cell lung cancer (NSCLC) patient characteristics, surgical factors, and postoperative complications was collected and analyzed. A nomogram model was constructed based on statistical regression analysis results, and the predictive performance of the model was evaluated.
ResultsThe average age of the patients was 67.07 ± 5.36 years. A total of 26.2% (113/432) patients had complications after thoracoscopic surgery. Logistic regression analysis showed that thoracic adhesion, history of respiratory disease, and FFA level were independent risk factors for complications after thoracoscopic surgery (P < 0.05). Based on the above factors, a nomogram risk model was constructed. The verification results showed that the area under curve (AUC) of the model was 0.728 (95%CI: 0.675 ~ 0.781), and the calibration curve showed that the model had good differentiation. The DCA (decision Curve Analysis) shows that this model has good clinical application value. In a subgroup analysis of complications, a history of respiratory disease and thoracic adhesion were identified as significant risk factors for postoperative pulmonary complications. LNs have been identified as an important risk factor for postoperative cardiovascular complications. The AUC of postoperative cardiac and pulmonary complications were 0.716 (95%CI: 0.653 ~ 0.779) and 0.703 (95%CI: 0.615 ~ 0.791), respectively. The calibration curve and DCA curve indicate that the model has good predictive performance and clinical application value.
ConclusionIn this study, the risk factors affecting the postoperative complications of thoracoscopic lung cancer in the elderly were analyzed, and the nomogram model built based on this has certain significance for the identification and reduction of postoperative complications.