关键词: 先天性脊柱侧凸, 术后肺部并发症, 影响因素, 预测模型

Abstract: Objective To analyze the incidence,influencing factors,and predictive efficacy of postoperative pulmonary complications in patients with congenital scoliosis (CS).Methods Clinical data of 280 patients with CS who successfully underwent scoliosis correction surgery in our hospital from January 2021 to February 2026 were retrospectively collected.According to the occurrence of postoperative pulmonary complications (PPCs) within 30 d after surgery,the patients were divided into a PPCs group and a non-PPCs group.Clinical data were collected.Logistic regression analysis was used to analyze the influencing factors for PPCs in patients with CS,and a Logit(P) regression prediction model was constructed.Receiver operating characteristic (ROC) curves,the Hosmer-Lemeshow (H-L) test,and Bootstrap internal validation were used to evaluate the predictive value of the model for PPCs.Results The incidence of PPCs among the 280 patients with CS was 22.14% (62/280).Univariate analysis showed that there were statistically significant differences between the two groups in age,preoperative Cobb angle,preoperative SII level,preoperative respiratory disease,number of fused segments,mid-thoracic screw placement,allogeneic red blood cell transfusion,thoracoplasty,operative time,and Cobb angle correction rate (P<0.05).Logistic regression analysis showed that increased preoperative Cobb angle,high preoperative SII level,preoperative respiratory disease,allogeneic red blood cell transfusion,thoracoplasty,and prolonged operative time were risk factors for PPCs in patients with CS (P<0.05).The regression equation was as follows:Logit(P) =-17.851+0.047×preoperative Cobb angle (°)+0.006×preoperative SII level+1.299×preoperative respiratory disease (no=0,yes=1)+0.942×allogeneic red blood cell transfusion (no=0,yes=1)+0.932×thoracoplasty (no=0,yes=1)+0.024×operative time (min).ROC curve analysis showed that the area under the curve (AUC) of this regression prediction model for predicting PPCs was 0.889.The calibration curve showed that the corrected curve was close to the ideal curve.Bootstrap internal validation showed that the C-index was 0.893.Conclusion Patients with CS have a relatively high risk of PPCs.Preoperative Cobb angle,preoperative SII level,preoperative respiratory disease,allogeneic red blood cell transfusion,thoracoplasty,and operative time can all affect the occurrence of PPCs.The prediction model constructed based on these factors has good predictive value and can be used for early clinical risk assessment and management.

Key words: congenital scoliosis, postoperative pulmonary complications, influencing factors, prediction model