Risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram model
Abstract Background Lung cancer is a leading cause of death in the elderly. Thoracoscopic surgery, though minimally invasive, poses a greater risk of postoperative atelectasis in this group owing to age and comorbidities. The aim of this study was to identify risk factors for atelectasis in elderly...
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BMC
2025-05-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-025-02939-0 |
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| author | Bin Liu Xi Chen Wuchang Deng |
| author_facet | Bin Liu Xi Chen Wuchang Deng |
| author_sort | Bin Liu |
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| description | Abstract Background Lung cancer is a leading cause of death in the elderly. Thoracoscopic surgery, though minimally invasive, poses a greater risk of postoperative atelectasis in this group owing to age and comorbidities. The aim of this study was to identify risk factors for atelectasis in elderly lung cancer patients and develop a nomogram model for clinical prediction. Methods Clinical data from 322 elderly patients with lung cancer were retrospectively analysed and split into a training set (n = 226) and a validation set (n = 96) at a 7:3 ratio. Independent risk factors for postoperative atelectasis were identified via univariate and multivariate logistic regression. A nomogram prediction model was constructed and evaluated for discrimination (ROC curves), calibration (Hosmer–Lemeshow test, calibration curves), and clinical utility (decision curve analysis, DCA). Results The multivariate logistic regression analysis revealed that the independent risk factors for postoperative atelectasis (P < 0.05) were age ≥ 70 years, a smoking history, decreased preoperative forced expiratory volume in one second (FEV1), and lobectomy. The areas under the ROC curves of the nomogram model were 0.826 (95% CI: 0.767–0.885) and 0.918 (95% CI: 0.802–0.991) in the training and validation sets, respectively. The calibration curves demonstrated a strong consistency between the predicted and observed outcomes. The DCA curves revealed that the model provided a high net clinical benefit when the threshold probability ranged from 0.07 to 0.60, with a maximum net benefit of 73%. Conclusion The independent risk factors identified for postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery are age ≥ 70 years, smoking history, reduced preoperative FEV1, and lobectomy. |
| format | Article |
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| institution | Kabale University |
| issn | 1471-2482 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Surgery |
| spelling | doaj-art-14d647fb06b64cd695f9e746e6b3b6e32025-08-20T03:53:57ZengBMCBMC Surgery1471-24822025-05-0125111110.1186/s12893-025-02939-0Risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram modelBin Liu0Xi Chen1Wuchang Deng2Department of Cardiothoracic Surgery, The 908th Hospital of Chinese People’s Liberation Army Joint Logistic Support ForceDepartment of Cardiothoracic Surgery, The 908th Hospital of Chinese People’s Liberation Army Joint Logistic Support ForceDepartment of Cardiothoracic Surgery, The 908th Hospital of Chinese People’s Liberation Army Joint Logistic Support ForceAbstract Background Lung cancer is a leading cause of death in the elderly. Thoracoscopic surgery, though minimally invasive, poses a greater risk of postoperative atelectasis in this group owing to age and comorbidities. The aim of this study was to identify risk factors for atelectasis in elderly lung cancer patients and develop a nomogram model for clinical prediction. Methods Clinical data from 322 elderly patients with lung cancer were retrospectively analysed and split into a training set (n = 226) and a validation set (n = 96) at a 7:3 ratio. Independent risk factors for postoperative atelectasis were identified via univariate and multivariate logistic regression. A nomogram prediction model was constructed and evaluated for discrimination (ROC curves), calibration (Hosmer–Lemeshow test, calibration curves), and clinical utility (decision curve analysis, DCA). Results The multivariate logistic regression analysis revealed that the independent risk factors for postoperative atelectasis (P < 0.05) were age ≥ 70 years, a smoking history, decreased preoperative forced expiratory volume in one second (FEV1), and lobectomy. The areas under the ROC curves of the nomogram model were 0.826 (95% CI: 0.767–0.885) and 0.918 (95% CI: 0.802–0.991) in the training and validation sets, respectively. The calibration curves demonstrated a strong consistency between the predicted and observed outcomes. The DCA curves revealed that the model provided a high net clinical benefit when the threshold probability ranged from 0.07 to 0.60, with a maximum net benefit of 73%. Conclusion The independent risk factors identified for postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery are age ≥ 70 years, smoking history, reduced preoperative FEV1, and lobectomy.https://doi.org/10.1186/s12893-025-02939-0Elderly lung cancer patientsThoracoscopyAtelectasisNomogramRisk factors |
| spellingShingle | Bin Liu Xi Chen Wuchang Deng Risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram model BMC Surgery Elderly lung cancer patients Thoracoscopy Atelectasis Nomogram Risk factors |
| title | Risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram model |
| title_full | Risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram model |
| title_fullStr | Risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram model |
| title_full_unstemmed | Risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram model |
| title_short | Risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram model |
| title_sort | risk assessment of postoperative atelectasis in elderly lung cancer patients undergoing thoracoscopic surgery based on a nomogram model |
| topic | Elderly lung cancer patients Thoracoscopy Atelectasis Nomogram Risk factors |
| url | https://doi.org/10.1186/s12893-025-02939-0 |
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