Significance of Relative Left Ventricle Wall Thickness in Predicting Acute Kidney Injury After Video-Assisted Thoracoscopic Surgery for Lung Cancer.

Abstract

Aims/Background Given the strong association between relative wall thickness (RWT) and cardiovascular dysfunction, this study aims to explore RWT as a novel cardiovascular indicator to predict the risk of acute kidney injury (AKI) after lung cancer surgery and guide clinical interventions. Methods This study retrospectively analyzed 170 patients who underwent video-assisted thoracoscopic surgery (VATS) for lung cancer in Nanjing First Hospital, China, between January 2022 and December 2023. Patients were divided into AKI group (n = 52) and non-AKI group (n = 118) based on the occurrence of AKI. Univariate analysis was performed to identify factors affecting the development of AKI in patients undergoing VATS for lung cancer. Moreover, multivariate logistic regression analysis was conducted to determine influencing factors. Correlation analysis was used to analyze the relationships between variables, and receiver operating characteristic (ROC) curve analysis was conducted to assess predictive ability. Results There were no statistically significant differences in gender, comorbidities, smoking history, tumor location, Tumor-Node-Metastasis (TNM) Staging System, tumor differentiation, neutrophil count, red blood cell count, white blood cell count, creatinine, urea nitrogen, intraoperative blood loss, and operation time (p > 0.05). The comparison of age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, mean arterial pressure, and RWT between the two groups showed statistically significant differences (p < 0.05). Multivariate logistic regression analysis indicated that age, APACHE II score, mean arterial pressure, and RWT significantly influenced the development of AKI in patients undergoing VATS for lung cancer (p < 0.05). RWT was negatively correlated with mean arterial pressure (r = -0.558, p < 0.05), and positively correlated with age and APACHE II Score (r = 0.573, 0.520, p < 0.05). Moreover, AKI showed a positive correlation with age, APACHE II Score, and RWT (r = 0.726, 0.685, 0.772, p < 0.05), and a negative correlation with mean arterial pressure (r = -0.724, p < 0.05). ROC analysis revealed that the area under the predicted curve for RWT was 0.864, and the standard error was 0.030 (95% confidence interval (CI): 0.805~0.923), with a Youden index of 0.55. At this time, the sensitivity was 87.29% and the specificity was 67.31%. Conclusion RWT shows excellent predictive value for postoperative AKI in patients undergoing VATS for lung cancer.