关键词: 非小细胞肺癌； 胸腔镜术； 心脏并发症； 危险因素； 模型构建

Abstract: Objective To explore the factors influencing the occurrence of cardiac complications after endoscopic surgery in patients with non-small cell lung cancer (NSCLC) and construct the prediction model.Methods A total of 312 patients with non-small cell lung cancer who were diagnosed and underwent thoracoscopic treatment in our hospital from January 2020 to January 2023 were selected as the objects of this study,and were divided into cardiac complication group and non-cardiac complication group according to whether cardiac complications occurred after surgery.The clinical data of patients in each group were analyzed,and the factors affecting the occurrence of cardiac complications in patients with non-small cell lung cancer after endoscopic surgery were discussed by multivariate Logistic regression analysis.A full-variable risk prediction model for the occurrence of cardiac complications was constructed,and the predictive model was verified by receiver operating characteristic curve (ROC) analysis.Results The incidence of postoperative cardiac complications in 312 patients with non-small cell lung cancer was 24.04%.Univariate analysis showed that Age,smoking history,smoking history,comorbidities,intraoperative blood loss,operative time,systolic blood pressure,FEV1,FEV1%,FPG,HbA1c and urinary microalbumin were correlated with the incidence of cardiac complications in patients with non-small cell lung cancer after endoscopic surgery (P<0.05).Multivariate Logistic stepwise regression analysis showed:age,comorbidities,operation time and HbA1c were independent risk factors for postoperative cardiac complications in patients with non-small cell lung cancer (P<0.05).A risk prediction model for cardiac complications was established based on multiple factors,that is,P = 1/ (1+ e-y),y=-3.114+ 0.881× age +0.754× complications +1.285× operation time + 1.185×HbA1c,and the ROC curve diagnosis showed that the risk prediction model predicted the occurrence of cardiac complications with an AUC of 0.847,95%CI of 0.769-0.925,sensitivity of 82.5%,specificity of 83.2%.Conclusion Age,complications,operation time,and HbA1c are all independent risk factors affecting the occurrence of cardiac complications in patients with non-small cell lung cancer after endoscopic surgery,and the risk prediction model constructed by the above factors has a good predictive value for the occurrence of cardiac complications.

Key words: non-small cell lung cancer; thoracoscopic surgery; cardiac complications; risk factors; model construction