应用Clavien-Dindo分级系统对肺癌患者术后并发症分级及危险因素分析

BACKGROUND AND OBJECTIVE: Postoperative complications (PCs) are contributing factors to patient mortality following lung resection. In this retrospective study, the Clavien-Dindo classification was used to analyze the current incidence of PCs and identify the risk factors of different grades of PCs. METHODS: A total of 966 lung cancer patients who underwent lobectomy in our department between June 2013 and December 2014 were retrospectively enrolled. Patients were divided into two groups depending on the occurrence of PCs. The PCs were classified into four grades through the Clavien-Dindo classification, and the related risk factors of different grades were evaluated. RESULTS: Approximately 15.0% (145/966) of patients had PC (total incidence: 39.3%, 380/966). Among the 380 cases with PCs, the proportions of Clavien-Dindo grade Ⅰ, grade Ⅱ, grade Ⅲ and grade Ⅳ or above complications were 6.8%, 75.3%, 15.0% and 2.9%, respectively. Binary Logistic regressions showed that preoperative forced expiratory volume in one second (FEV(1)), diffusion capacity for carbon monoxide of the lung (single breath)(DLco SB), and preoperative combined chronic obstructive pulmonary disease were the significant independent factors for PCs. FEV(1) in preoperative pulmonary function was the significant risk factor for complications at Clavien-Dindo grade Ⅰ, grade Ⅱ, grade Ⅲ, and above. CONCLUSION: Clavien-Dindo grade Ⅱ complications are the most common complications within 30 days after lung cancer lobectomy. FEV(1) is closely related to the occurrence of PCs and may potentially be one of the practical variables to assess the risk of occurrence of PCs.