Abstract： Objective To analyze possible associated risk factors of postoperative pulmonary complications (PPC) after lung resection in order to decrease the incidence and mortality of PPC. Methods We reviewed the data of 302 patients including 228 males and 74 females undergoing lung resection from January 2007 to December 2009 in our department. The age of the patients ranged from 23 to 91 years old with an average age of 63.38 years. Based on the present definition of PPC, we recorded the related information and data before, during and after the operation, and observed the rate of PPC. The independent risk factors of PPC were evaluated by multiple logistic regression analysis. Results A total of 22 patients (7.28%) died during the operation and 75 patients (24.83%) experienced 110 times of PPC, the majority of which were prolonged air leak/bronchopleural fistula (8.94%, 27/302), nosocomial pneumonia (6.95%, 21/302) and acute respiratory failure (6.29%, 19/302). The results of logistic regression analysis showed that an American Society of Anesthesiology (ASA) score ≥3 (OR=2.400，P=0.020) and prolonged duration of immediate postoperative mechanical ventilation (OR=1.620，P=0.030) were independent factors associated with the development of PPC.Conclusions The ASA score based on the patients’ general condition and the function status of the main organs, and the prolonged duration of immediate postoperative mechanical ventilation are independent risk factors of PPC. In order to decrease the PPC rate, more attention should be paid to perfecting preoperative preparation, improving the function and condition of the organs, preserving pulmonary function and decreasing the duration of immediate postoperative mechanical ventilation for patients with high risk factors.
ObjectiveTo investigate the characteristics and prognostic value of cellular immune function in severe patients with coronavirus disease 2019 (COVID-19).MethodsA cohort study was conducted to collect the clinical data of 119 severe patients admitted to the Renmin Hospital of Wuhan University (Eastern District) including 60 males (50.4%) and 59 females (49.6%), with an average age of 60.9±14.2 years. The primary endpoint of follow-up was death in the hospital, and the disease outcome classification was the secondary endpoint of follow-up within 30 days after admission. We analyzed the correlation between cellular immune function and COVID-19 prognosis.Results A total of 22 patients died during this process, and 47 patients were severe/critical during the follow-up period. The counts of CD3+, CD4+, CD8+, and CD19+ in the primary endpoint events were significantly different between the survival group and the death group (all P<0.05). The counts of CD3+, CD4+, CD8+, CD19+ in the secondary endpoint events were significantly different between the normal group and the severe/critical group (all P<0.05). The results of the receiver operating characteristic (ROC) curve showed that the area under the cellular immune function curve of dead patients and severe/critical patients had good predictive value (all P<0.05).ConclusionCell immune function has good clinical and prognostic value for COVID-19.