The role of low-dose glucocorticoids in preventing bronchopleural fistula after bronchoplasty: a retrospective study.

Abstract

Objectives: The aim of this study was to evaluate the clinical significance of early administration of low-dose corticosteroids after bronchoplasty, for the prevention of bronchopleural fistula (BPF).

Methods: A total of 356 patients who underwent bronchoplasty in our hospital from 2019 to 2023 were retrospectively included. Univariate and multivariate logistic regression methods were used to determine the factors affecting the occurrence of BPF, and the significant factors were screened for Receiver Operating Characteristics (ROC) curves.

Results: A total of 356 patients who underwent bronchoplasty were included in this study, 12 of whom developed BPF. Univariate and multivariate logistic regression analysis results showed that Preoperative serum albumin level (odds ratio (OR) = 0.64, 95% confidence interval (CI): 0.52-0.78, P < 0.01), low-dose glucocorticoid (OR = 0.11, 95% CI: 0.01-0.89, P = 0.038) were significant factors affecting postoperative BPF. Subsequently, the ROC curves of glucocorticoid and preoperative serum albumin level affecting the occurrence of BPF showed that low-dose glucocorticoids and preoperative albumin level were significantly correlated with the occurrence of BPF [Area Under Curves (AUC) = 0.681, AUC = 0.860], and the model had good prediction accuracy.

Conclusions: Early use of low-dose glucocorticoids after bronchoplasty was associated with a reduced incidence of BPF, suggesting a potential role in preventing this complication. Preoperative serum albumin levels were identified as an independent risk factor for BPF, and it is recommended that a comprehensive assessment of the patient's nutritional status, including but not limited to serum albumin levels, be performed during preoperative management to optimize preoperative management and reduce the occurrence of BPF.