Abstract:

Objective

To analyze the risk factors in postoperative delirium （POD） in primary lung cancer and predict prognosis.

Methods

All of 337 patients admitted to intensive care unit after primary lung cancer resection in our hospital from February 2018 to March 2023 were selected. 27 patients with postoperative delirium were included in the observation group and 310 patients without postoperative delirium were included in the control group. Clinical data were collected. LASSO regression analysis and multiple Logistic regression were used to analyze the risk factors of postoperative delirium after primary lung cancer resection. Postoperative delirium occurrence， overall survival （OS） and disease-free survival （DFS） were recorded， and the relationship between postoperative delirium occurrence and prognosis was analyzed.

Results

The risk factors of postoperative delirium were cerebrovascular disease， squamous cell carcinoma and age ＞71 years old. The simplified formula of risk score is： 1× （age＞71 years） +1×（squamous cell carcinoma） +1× （cerebrovascular disease）. The receiver operating characteristic curve （ROC） for predicting postoperative delirium risk was 0.840 （95%CI： 0.796 ～0.877）， when risk score ＞1， sensitivity and specificity were 74.07% and 85.48%，respectively. The postoperative delirium incidence was 1.50%， 3.60%， 22.41% and 100.0% （P＜0.05） in patients with risk scores 0 to 3， respectively. By the end of follow-up， 147 cases （43.62%） had relapsed and 95 cases （28.19%） had died in 337 cases of lung cancer， there were 6 deaths （22.22%）among 27 patients in the observation group and 35 deaths（11.29%） among 310 patients in the control group. The DFS of the observation group was 10.00 （4.00-43.00） months， and that of the control group was 10.00 （3.00-91.00）months （P＞0.05）. The OS 33.00 （8.00-68.00） months in the observation group was shorter than that in the control group 39.50 （3.00-69.00） months （P＜0.05）.

Conclusion

The prediction of postoperative delirium risk score after primary lung cancer resection has clinical significance， and the patients with postoperative delirium have shorter overall survival.

Key words: Primary lung cancer resection, Postoperative delirium, Risk scoring system, Prognosis