Correlation of lung ultrasound score with postoperative pulmonary complications in older adults undergoing thoracoscopic lobectomy: a prospective observational study

Abstract

Background

It is unclear whether postoperative pulmonary complications (PPC) can be early predicted by lung ultrasound (LUS) score in older adults undergoing thoracoscopic lobectomy. This study aimed to evaluate the validity of lung ultrasound application.

Methods

Two physicians performed lung ultrasonography on patients preoperatively, 30 min postoperatively and 72 h postoperatively to obtain LUS score. Pulmonary complications occurred within 10 days postoperatively were recorded. The correlation between lung ultrasound results and PPC was analyzed using logistic regression model. ROC curve were applied to assess the prediction accuracy.

Results

PPC occurred in 115 of 292 patients (39.38%) in this study. Independent risk factors for PPC included higher age (OR 1.16, 95% CI 1.04–1.29, p = 0.007), COPD comorbidity (OR 5.03, 95% CI 1.29–19.59, p = 0.020), lower preoperative hemoglobin level (OR 0.96, 95% CI 0.93–1.00, p = 0.043), and higher postoperative 30 min LUS score (OR 1.32, 95% CI 1.22–1.43, p < 0.001). Postoperative 30 min lung ultrasound score (AUC: 0.811, cut-off: 14) shown in the ROC curve analysis was effective in predicting postoperative outcomes.

Conclusions

Postoperative 30 min lung ultrasound score is a risk factor for PPC in older adults undergoing thoracoscopic lobectomy in this study. The value of lung ultrasound as a predictive tool for PPC is warranted.

Trial Registry: This study was registered in China Clinical Trial Registry (ChiCTR2100053449).

Highlights

Older adults undergoing thoracoscopic lobectomy showed a high rate of PPC (39.38%).

Postoperative 30 min lung ultrasound score was a significant risk factor for PPC. (OR 1.32 95% CI 1.22–1.43 p < 0.001).

A highly predictive indicator of PPC was the postoperative 30 min lung ultrasound score (AUC 0.811).