内容紹介
Summary
Patients and methods: Four hundred and nineteen patients with colorectal cancer who underwent laparotomy were included in this study. Indicators that reflected immunity, nutrition, and physical function were selected, and risks associated with the presence of postoperative pneumonia were investigated. Cut-off values of factors affecting the occurrence of pneumonia were determined using the receiver-operating characteristic curve approach. Results: Pneumonia was observed in 2.9% of the patients, and PNI(≤40.0), CONUT(≥2), BMI(<18.5 kg/m2), PS(≥1), %VC(<80.0%), and FEV1.0%(<70.0%)were identified as risk factors in multivariate analysis(p<0.05). %VC(<80.0%)was extracted as an independent factor. The cut-off value of %VC was determined to be 80.0% based on the incidence of postoperative pneumonia. Conclusion: Low volume in %VC(<80.0%)may be a risk factor for pneumonia after resection of colorectal cancer.
要旨
目的: 開腹大腸癌手術における術後肺炎の発症に免疫・栄養状態や身体機能が与える影響について検討した。対象と方法: 開腹大腸癌手術が施行された419例を対象とした。術後肺炎の発症に影響する免疫・栄養・身体機能の因子を検討した。また,有意な危険因子については術後肺炎の発症頻度から,receiver operating characteristic curve(ROC曲線)を用いてカットオフ値を求めた。結果: 肺炎発症(2.9%)に単変量解析では,小野寺式栄養指数,controlling nutritional status,BMI,PS,%VC,FEV1.0%が肺炎の危険因子として抽出され,多変量解析では%VCのみが独立した危険因子であった。術後肺炎の発生頻度から求めた%VCのカットオフ値は80.0%(AUC 0.89,感度83.3%,特異度87.7%)であった。結語: 開腹大腸癌手術において術前%VC 80.0%未満は術後肺炎発症の危険因子であることが示唆された。
目次
Patients and methods: Four hundred and nineteen patients with colorectal cancer who underwent laparotomy were included in this study. Indicators that reflected immunity, nutrition, and physical function were selected, and risks associated with the presence of postoperative pneumonia were investigated. Cut-off values of factors affecting the occurrence of pneumonia were determined using the receiver-operating characteristic curve approach. Results: Pneumonia was observed in 2.9% of the patients, and PNI(≤40.0), CONUT(≥2), BMI(<18.5 kg/m2), PS(≥1), %VC(<80.0%), and FEV1.0%(<70.0%)were identified as risk factors in multivariate analysis(p<0.05). %VC(<80.0%)was extracted as an independent factor. The cut-off value of %VC was determined to be 80.0% based on the incidence of postoperative pneumonia. Conclusion: Low volume in %VC(<80.0%)may be a risk factor for pneumonia after resection of colorectal cancer.
要旨
目的: 開腹大腸癌手術における術後肺炎の発症に免疫・栄養状態や身体機能が与える影響について検討した。対象と方法: 開腹大腸癌手術が施行された419例を対象とした。術後肺炎の発症に影響する免疫・栄養・身体機能の因子を検討した。また,有意な危険因子については術後肺炎の発症頻度から,receiver operating characteristic curve(ROC曲線)を用いてカットオフ値を求めた。結果: 肺炎発症(2.9%)に単変量解析では,小野寺式栄養指数,controlling nutritional status,BMI,PS,%VC,FEV1.0%が肺炎の危険因子として抽出され,多変量解析では%VCのみが独立した危険因子であった。術後肺炎の発生頻度から求めた%VCのカットオフ値は80.0%(AUC 0.89,感度83.3%,特異度87.7%)であった。結語: 開腹大腸癌手術において術前%VC 80.0%未満は術後肺炎発症の危険因子であることが示唆された。