To Study The Correlation Between SII-PNI And Charlson Comorbidity Index And Severe Complications In Perioperative Period Of Lung Cancer

Objective: To study the predictive value of preoperative SII combined with PNI for severe perioperative complications of lung cancer,and to explore the related risk factors of severe perioperative complications of lung cancer.Methods: The clinical data of 557 patients who underwent lung cancer surgery in our hospital from January 1,2021 to September 10,2021 were retrospectively collected.The receiver operating characteristic curve(ROC curve)was established by drawing various inflammatory indicators.The Youden index was calculated,and the maximum value of the Youden index was taken as the best cut-off value.The area under the ROC curve(AUC)was calculated.According to the cutoff value,patients were divided into high SII-high PNI group,high SII-low PNI group,low SII-high PNI group,and low SII group-low PNI group.According to the Clavien-Dindo classification,complications of grade III or higher were considered as severe perioperative complications.logistic regression model was used for univariate and multivariate analysis to identify the independent risk factors for severe perioperative complications in patients with lung cancer.Results: Among 497 patients with NSCLC,44 had severe perioperative complications.The optimal cutoff time of SII and PNI was485.299 and 54.225,respectively.Univariate logistic analysis showed that preoperative high SII combined with low PNI(P<0.05),low SII combined with low PNI(P<0.05),with preoperative hypertension(P<0.05),coronary heart disease(P<0.05),COPD(P<0.05),diabetes(P<0.05),stroke(P<0.05),Charlson comorbidity index(CCI≥3)(P<0.05),smoking(P<0.05),alcohol consumption(P<0.05),TNM stage(≥3 stage)(P<0.05),ASA grade(≥3)(P<0.05),intraoperative blood loss(P<0.05),intraoperative urine volume(P<0.05),total intraoperative fluid intake(P<0.05),operation time(P<0.05)and duration of anesthesia(P<0.05)were significantly associated with an increased risk of major perioperative complications.Multivariate stepwise regression analysis confirmed COPD(P<0.05)and diabetes(P<0.05)were the independent risk factors for perioperative severe complications.Analyzing the secondary outcomes,SII combined with PNI had a significant predictive effect on patients with lung cancer who were admitted to the intensive care unit for more than one day after surgery(P<0.05).Conclusions: The prognostic significance of blood biomarkers in patients with non-small cell lung cancer has been established.The combination of SII and PNI is not an effective predictor of severe perioperative complications in patients with lung cancer.Patients with COPD and diabetes are prone to severe perioperative complications.It is necessary to actively formulate perioperative management strategies and take effective measures to reduce the occurrence of severe perioperative complications in patients with lung cancer.