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Perioperative Factors for Predicting the Need for Postoperative Intensive Care after Major Lung Resection

Authors
 Seung Hyun Kim  ;  Sungwon Na  ;  Seong Yong Park  ;  Jinae Lee  ;  Yhen-Seung Kang  ;  Hwan-ho Jung  ;  Jeongmin Kim 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.8(5) : E744-12, 2019 
Journal Title
 JOURNAL OF CLINICAL MEDICINE 
Issue Date
2019
Keywords
intensive care ; major lung resection ; perioperative risk factors
Abstract
Postoperative management after major lung surgery is critical. This study evaluates risk factors for predicting mandatory intensive care unit (ICU) admission immediately after major lung resection. We retrospectively reviewed patients for whom the surgeon requested an ICU bed before major lung resection surgery. Patients were classified into three groups. Univariable and multivariable logistic regression analyses were performed, and a clinical nomogram was constructed. Among 340 patients, 269, 50, and 21 were classified into the no need for ICU, mandatory ICU admission, and late-onset complication groups, respectively. Predictive postoperative diffusion capacity of the lung for carbon monoxide (47.2 (interquartile range (IQR) 43.3-65.7)% versus vs. 67.8 (57.1-79.7)%; p = 0.003, odds ratio (OR) 0.969, 95% confidence interval (CI) 0.95-0.99), intraoperative blood loss (400.00 (250.00-775.00) mL vs. 100.00 (50.00-250.00) mL; p = 0.040, OR 1.001, 95% CI 1.000-1.002), and open thoracotomy (p = 0.030, OR 2.794, 95% CI 1.11-7.07) were significant predictors for mandatory ICU admission. The risk estimation nomogram demonstrated good accuracy in estimating the risk of mandatory ICU admission (concordance index 83.53%). In order to predict the need for intensive care after major lung resection, preoperative and intraoperative factors need to be considered.
Files in This Item:
T201901801.pdf Download
DOI
10.3390/jcm8050744
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Seung Hyun(김승현) ORCID logo https://orcid.org/0000-0003-2127-6324
Kim, Jeongmin(김정민) ORCID logo https://orcid.org/0000-0002-0468-8012
Na, Sungwon(나성원) ORCID logo https://orcid.org/0000-0002-1170-8042
Park, Seong Yong(박성용) ORCID logo https://orcid.org/0000-0002-5180-3853
Lee, Jinae(이진애)
Jung, Hwan Ho(정환호) ORCID logo https://orcid.org/0000-0002-3819-2744
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170083
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