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【文摘发布】超过70岁患者施行全肺切除术的危险
The risk of pneumonectomy over the age of 70.
A case–control study
Objective: A higher mortality has been reported after pneumonectomy over the age of 70. The aim of the study was to quantify the additional risk due to age after standard pneumonectomy for lung cancer by a case–control study. Methods: Our clinical database was reviewed to search for patients aged 70 years or more who underwent standard pneumonectomy for lung cancer between 1998 and 2005. A control group of patients younger than 70 (one case/two controls) was matched for sex, cardiovascular disease, American Association of Anaesthetists score, respiratory function, side of pneumonectomy, induction chemotherapy and stage. Overall mortality and morbidity were compared. Long-term survival data were also analysed. Results: During the considered period, 35 patients aged 70 years or more underwent pneumonectomy (30 males, median age 73 years, 15 right-sided procedures). The control group was composed of 70 patients. The two groups were homogeneous in the variables used for matching. Overall mortality and morbidity were 11.4 and 54.2% in the elderly group as compared to 4.3 and 41.6% in controls (p-value not significant). Elderly patients experienced a higher rate of respiratory complications (25.7%) as compared to controls (8.3%, p = 0.01). At univariate analysis, the only risk factor for death was the occurrence of respiratory complications (OR 6.5, CI 1.8–18.2). At multivariate analysis, age 70 years (OR 5.36, CI 1.48–19.3) and preoperative chemotherapy (OR 7.65, CI 2.04–28.6) were confirmed as predictors of respiratory complications. Five-year survival was 17.5% in the elderly group and 53.6% in the control group (p = 0.003). Elderly patients with a better respiratory function (FEV1 > 70%) had a 5-year survival of 45.4%. Conclusions: In the elderly patients, the risk of respiratory complications after pneumonectomy is increased as compared to younger patients with equivalent respiratory function. Age and preoperative chemotherapy are independent risk factors for respiratory complications. A lower mortality and a better long-term survival are obtained in elderly patients with a better respiratory function (FEV1 70%).
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http://ejcts.ctsnetjournals.org/cgi/gca?sendit=Get+All+Checked+Abstract%28s%29&gca=31%2F5%2F759&gca=31%2F5%2F765&gca=31%2F5%2F772&gca=31%2F5%2F779&gca=31%2F5%2F783&gca=31%2F5%2F791&gca=31%2F5%2F797&gca=31%2F5%2F802&gca=31%2F5%2F806 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 初译：
Eur J Cardiothorac Surg 2007;31:779-782.
The risk of pneumonectomy over the age of 70. A case–control study
超过70岁患者施行全肺切除术的风险（病例对照研究）
Objective: A higher mortality has been reported after pneumonectomy over the age of 70. The aim of the study was to quantify the additional risk due to age after standard pneumonectomy for lung cancer by a case–control study.
目的：据报道超过70岁患者行肺切除术后有更高的死亡率。研究目的在于通过肺癌患者行标准的肺切除术后的病例对照来定量因年龄所致的额外风险。[标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-03-13 17:12
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