The neutrophil-to-lymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)are found to increase in patients who develop postoperative complications(PCs).The aim of the present study was to explore the associatio...The neutrophil-to-lymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)are found to increase in patients who develop postoperative complications(PCs).The aim of the present study was to explore the association of the perioperative changes of NLR(ANLR)and PLR(OPLR)with PCs in non-small cell lung cancer(NSCLC).Clinical data of 509 patients,who were diagnosed with NSCLC and underwent thoracoscopic radical resection between January 1,2014 and July 31,2016 at the Department of Thoracic Surgery,West China Hospital,were reviewed.Patients were divided into PC and non-PC groups,and clinical characteristics including ANLR and APLR were compared between them.The optimal cut-off values of ONLR and APLR were determined by receiver operating characteristics(ROC)curves and patients were assigned to high ANLR/APLR and low ONLR/OPLR groups in terms of the cut-off values.Clinicopathologic characteristics and the incidence of different PCs were compared between the dichotomized groups.Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for PCs.The results showed that the ANLR and APLR in the PC group were significantly higher than those in the non-PC group(P<0.001 for both).The optimal cutoff values of ANLR and APLR were 6.6 and 49,respectively.Patients with ANLR>6.6 or 0PLR>49 were more likely to experience postoperative pulmonary complications(PPCs)(P<0.001 for both).Multivariate logistic regression analysis demonstrated that smoking[odds ratio(OR):2.450,95%confidence interval(95%CI):1.084--5.535,P=0.031)],tumor size(OR:1.225,95%CI:1.047-1.433,P=0.011),ANLR>6.6(OR:2.453,95%CI:1.2244.914,P-0.011)and APLR>49(OR:2.231,95%CI:1.182-4.212,P-0.013)were predictive of PPCs.In conclusion,the ONLR and APLR may act as novel predictors for PPCs in NSCLC patients undergoing thoracoscopic radical lung resection,and patients with ONLR>6.6 or APLR>49 should be treated more actively to prevent or reduce PPCs.展开更多
Objective： To evaluate the effects of preoperative inspiratory muscle training （IMT） on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective total hi...Objective： To evaluate the effects of preoperative inspiratory muscle training （IMT） on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective total hip replacement surgery under general anesthesia. Methods： Thirty two high-risk patients undergoing elective total hip replacement surgery under general anesthesia were chosen from Nanjing Medical University, Affiliated Nanjing First Hospital. In this single-blind randomized controlled clinical triM, patients were randomly assigned to receive preoperative inspiratory muscle training or conventional treatment （CT）. The major effectiveness outcome variables were atelectasis and duration of postoperative hospitalization. Results： Both groups were comparable prior to surgery. Seven patients in the CT group and 3 in the IMT group developed atelectasis （P = 0.25）. Median duration of postoperative hospitalization was 13 days （range, 10～17 days） in the IMT group versus 16 days （range, 11～23 days） in the CT group （Mann- Whitney U statistics, Z = -2.22, P = 0.03）. Mean postoperative inspiratory pressure was 5% higher in the IMT group. Conclusion： Preoperative intensive inspiratory muscle training appears to reduce the incidence of atelectasis and duration of postoperative hospitalization in patients at high risk of developing postoperative pulmonary complications who were scheduled for elective total hip replacement surgery under general anesthesia.展开更多
AIM: To identify the risk factors for postoperative pulmonary complications (PPC) after gastrointestinal surgery. METHODS: A total of 1 002 patients undergoing gastrointestinal surgery in the Second Affiliated Hospita...AIM: To identify the risk factors for postoperative pulmonary complications (PPC) after gastrointestinal surgery. METHODS: A total of 1 002 patients undergoing gastrointestinal surgery in the Second Affiliated Hospital, Sun Yat-Sen University, during December 1999 and December 2003, were retrospectively studied. RESULTS: The overall incidence of PPC was 22.8% (228/ 1 002). Multivariate logistic analysis identified nine risk factors associated with PPC, including age odds ratio (OR = 1.040) history of respiratory diseases (OR = 2.976), serum albumin (OR = 0.954), chemotherapy 2 wk before operation (OR = 3.214), volume of preoperative erythrocyte transfusion (OR = 1.002), length of preoperative antibiotic therapy (OR = 1.072), intraoperative intratracheal intubation (OR = 1.002), nasogastric intubation (OR = 1.050) and postoperative mechanical ventilation (OR = 1.878). Logistic regression equation for predicting the risk of PPC was P(1) =q/[1+e-(-3.488+0.039×+1.090×Rd+0.001×Rbc-0.0047×Alb+0.002×Lii+ 0.049×Lni+0.630×Lmv+0.070×Dat+1.168×a)].展开更多
文摘The neutrophil-to-lymphocyte ratio(NLR)and the platelet-to-lymphocyte ratio(PLR)are found to increase in patients who develop postoperative complications(PCs).The aim of the present study was to explore the association of the perioperative changes of NLR(ANLR)and PLR(OPLR)with PCs in non-small cell lung cancer(NSCLC).Clinical data of 509 patients,who were diagnosed with NSCLC and underwent thoracoscopic radical resection between January 1,2014 and July 31,2016 at the Department of Thoracic Surgery,West China Hospital,were reviewed.Patients were divided into PC and non-PC groups,and clinical characteristics including ANLR and APLR were compared between them.The optimal cut-off values of ONLR and APLR were determined by receiver operating characteristics(ROC)curves and patients were assigned to high ANLR/APLR and low ONLR/OPLR groups in terms of the cut-off values.Clinicopathologic characteristics and the incidence of different PCs were compared between the dichotomized groups.Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for PCs.The results showed that the ANLR and APLR in the PC group were significantly higher than those in the non-PC group(P<0.001 for both).The optimal cutoff values of ANLR and APLR were 6.6 and 49,respectively.Patients with ANLR>6.6 or 0PLR>49 were more likely to experience postoperative pulmonary complications(PPCs)(P<0.001 for both).Multivariate logistic regression analysis demonstrated that smoking[odds ratio(OR):2.450,95%confidence interval(95%CI):1.084--5.535,P=0.031)],tumor size(OR:1.225,95%CI:1.047-1.433,P=0.011),ANLR>6.6(OR:2.453,95%CI:1.2244.914,P-0.011)and APLR>49(OR:2.231,95%CI:1.182-4.212,P-0.013)were predictive of PPCs.In conclusion,the ONLR and APLR may act as novel predictors for PPCs in NSCLC patients undergoing thoracoscopic radical lung resection,and patients with ONLR>6.6 or APLR>49 should be treated more actively to prevent or reduce PPCs.
文摘Objective： To evaluate the effects of preoperative inspiratory muscle training （IMT） on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective total hip replacement surgery under general anesthesia. Methods： Thirty two high-risk patients undergoing elective total hip replacement surgery under general anesthesia were chosen from Nanjing Medical University, Affiliated Nanjing First Hospital. In this single-blind randomized controlled clinical triM, patients were randomly assigned to receive preoperative inspiratory muscle training or conventional treatment （CT）. The major effectiveness outcome variables were atelectasis and duration of postoperative hospitalization. Results： Both groups were comparable prior to surgery. Seven patients in the CT group and 3 in the IMT group developed atelectasis （P = 0.25）. Median duration of postoperative hospitalization was 13 days （range, 10～17 days） in the IMT group versus 16 days （range, 11～23 days） in the CT group （Mann- Whitney U statistics, Z = -2.22, P = 0.03）. Mean postoperative inspiratory pressure was 5% higher in the IMT group. Conclusion： Preoperative intensive inspiratory muscle training appears to reduce the incidence of atelectasis and duration of postoperative hospitalization in patients at high risk of developing postoperative pulmonary complications who were scheduled for elective total hip replacement surgery under general anesthesia.
文摘AIM: To identify the risk factors for postoperative pulmonary complications (PPC) after gastrointestinal surgery. METHODS: A total of 1 002 patients undergoing gastrointestinal surgery in the Second Affiliated Hospital, Sun Yat-Sen University, during December 1999 and December 2003, were retrospectively studied. RESULTS: The overall incidence of PPC was 22.8% (228/ 1 002). Multivariate logistic analysis identified nine risk factors associated with PPC, including age odds ratio (OR = 1.040) history of respiratory diseases (OR = 2.976), serum albumin (OR = 0.954), chemotherapy 2 wk before operation (OR = 3.214), volume of preoperative erythrocyte transfusion (OR = 1.002), length of preoperative antibiotic therapy (OR = 1.072), intraoperative intratracheal intubation (OR = 1.002), nasogastric intubation (OR = 1.050) and postoperative mechanical ventilation (OR = 1.878). Logistic regression equation for predicting the risk of PPC was P(1) =q/[1+e-(-3.488+0.039×+1.090×Rd+0.001×Rbc-0.0047×Alb+0.002×Lii+ 0.049×Lni+0.630×Lmv+0.070×Dat+1.168×a)].
