Risk factors and prediction model construction for atrial fibrillation in elderly patients after thoracoscopic lung cancer resection
Objective To investigate the influencing factors of atrial fibrillation(AF)after thoracoscopic resection in elderly patients with lung cancer and to construct a corresponding risk prediction model.Methods A retrospective analysis was conducted on the data of 184 elderly lung cancer patients whicch iclcde 94 male and 90 demale,the age range is(65.2±4.2)who underwent thoracoscopic resection at the Thoracic Surgery Department of Cancer Hospital,Chinese Academy of Medical Sciences from July 2022 to December 2023.The incidence of AF after thoracoscopic resection in these patients was statistically analyzed.Univariate and multivariate logistic regression analyses were used to explore the influencing factors of AF occurrence after thoracoscopic resection in elderly lung cancer patients.Based on these influencing factors,a nomogram prediction model was constructed,and its accuracy was evaluated using the receiver operating characteristic(ROC)curve,followed by calibration curve validation.Results The incidence of AF after thoracoscopic resection in elderly lung cancer patients was 9.2%(17/184).Univariate analysis showed that gender,history of cardiovascular disease,preoperative pulmonary infection,postoperative oxygen partial pressure,and wound pain score were related to the occurrence of AF after thoracoscopic resection in elderly lung cancer patients(all P＜0.05).Multivariate logistic regression analysis showed that male gender,history of cardiovascular disease,low oxygen partial pressure,and preoperative pulmonary infection were independent risk factors for the occurrence of AF after thoracoscopic resection in elderly lung cancer patients(P＜0.05).The area under the ROC curve for evaluating the prediction model was 0.854,with a sensitivity of 82.6%and a specificity of 81.5%.Internal validation using the Bootstrap method yielded a C-index of 0.801,and the calibration curve of the prediction model fit well with the ideal curve.Conclusion The incidence of AF after thoracoscopic resection in elderly lung cancer patients is relatively high.Male gender,history of cardiovascular disease,low oxygen partial pressure,and preoperative pulmonary infection are independent risk factors for the occurrence of AF after thoracoscopic resection in elderly lung cancer patients.The risk prediction model constructed based on these risk factors has good predictive performance.
Lung neoplasmsThoracoscopic ResectionElderly PatientsAtrial FibrillationRisk FactorsPrediction Model
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