Multiplevariate Logistic Analysis Of Postoperative Respiratory Failure And Establishment Of Risk Model In Lung Cancer Rection

Objective:To investigate the main risk factors of postoperative Respiratory Failure in lung cancer rection,to establish the Logistic regression model and to evaluate the accuracy,sensitivity and specificity for predicting postoperative respiratory failure.Methods:Case-control study was used to retrospectively investigate the clinical data of 120 lung cancer cases.Firstly,single factor analysis including Independent-sample T Test for scale variables,Chi-squareTest for binomial and nominal variables,Nonparametric Test for ordinal variables,was used in 50 clinical variables.Then,multiplevariate Logistic regression analysis equation was used in the selected variables.At last,the Logistic regression was set up: P=Exp(β₀+∑β_iX_i)/1+Exp(β₀+∑β_iX_i),the relative risk(RR)was calculated with the odds ratio(OR)approximately,OR=Exp(β),and the accuracy,sensitivity and specificity of the model was evaluated individually.Results:14 clinical variables,including accompanied with respiratory diseases preoperative especially COPD;Body mass Index(BMI),Cigarettes Index(CI), Spirometry mediastinal lymphadenectomy(SML),diameter of tumor,blood loss during operation,fluid infusion volume in the operation day,operative time, pneumono resection method,TNM by stages were selected through single factor analysis.By entering these factors into stepwise Logistic regression analysis, it was revealed that there were 6 significant factors complications in diminishing equence as accompanied with respiratory diseases especially COPD(OR=2.727),FEV₁＜1.5L(OR=2.457),Systematic Mediastinal Lymphad-ectomyOR=1.958), and blood loss during operation(OR=1.573),igarettes Index(OR=1.243),Body mass Index(OR=1.186).Logistic regression equation: P=1/1+Exp(3.327-1.002X₁-0.889 X₂-0.453X₃-0.342X₄-0.231X₅-0.216 X₆);The sensitivity,specificity and accuracy of the Logistic model were 53.12%17/32), 78.41%(69/88),71.67%(86/120)respectively.Conclusion respiratory diseases especially COPD,FEV₁＜1.5L,Systematic Mediastinal Lymphadenectomy(SML),blood loss during operation,Cigarettes Index(CI),Body mass Index(BMI)were the main risk factors of postoperative respiratory failure in lung cancer rection,The Logistic regressive model based on these factors is reliable in predicting the postoperative respiratory failure.