Journal of thoracic disease最新文献

{"title":"Upper respiratory tract commensal <i>Streptococcus oralis</i> inhibits mycobacterial growth by producing bioactive molecules and inducing macrophage autophagy.","authors":"Jiawen Liu, Ying Peng, Hongbo Shen, Wei Sha","doi":"10.21037/jtd-2026-2039","DOIUrl":"https://doi.org/10.21037/jtd-2026-2039","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is caused by <i>Mycobacterium tuberculosis</i> (Mtb) and remains a major global health challenge. Although host immunity is critical for controlling infection, the role of upper respiratory tract commensal microbiota in anti-mycobacterial defense remains unclear. This study investigated whether commensal bacteria from close contacts of patients with TB, who remained persistently tuberculin skin test- (TST) and QuantiFERON-TB (QFT) Gold-negative after long-term exposure, produce factors capable of inhibiting mycobacterial growth.</p><p><strong>Methods: </strong>Throat swabs were collected from close contacts of patients with TB and subjected to <i>ex vivo</i> enrichment culture. Cell-free microbial culture supernatants were tested for activity against Bacillus Calmette-Guérin (BCG), H37Rv, and <i>Mycobacterium smegmatis (M. smegmatis</i>) in cell-free culture and THP-1-derived macrophage infection models. Microbiota composition was analyzed by 16S ribosomal ribonucleic acid (rRNA) gene amplicon sequencing, and functional strains were isolated and identified by whole-genome sequencing. The physicochemical properties of active components were examined using ethanol precipitation and proteinase K digestion. Autophagy-related proteins were assessed by Western blotting, and <i>in vivo</i> activity was evaluated in mouse models of <i>M. smegmatis</i> and BCG infection.</p><p><strong>Results: </strong>Supernatants from selected throat swab cultures significantly inhibited mycobacterial growth and reduced intracellular bacterial burdens in macrophages. Microbiota analysis and functional screening identified <i>Streptococcus oralis</i> (<i>S. oralis</i>) as a candidate anti-mycobacterial commensal. The culture supernatant of an isolated <i>S. oralis</i> strain inhibited BCG, H37Rv, and <i>M. smegmatis</i>, and decreased intracellular mycobacterial survival. Its activity was enriched in ethanol-precipitated fractions and was markedly reduced after proteinase K digestion, suggesting proteinaceous or peptide-like active components. Treatment with <i>S. oralis</i> supernatant reduced mTOR and p62 expression and increased LC3B-II abundance, consistent with activation of autophagy-related pathways. Oral administration of the supernatant reduced bacterial loads in mouse infection models.</p><p><strong>Conclusions: </strong>Upper respiratory tract-derived <i>S. oralis</i> may contribute to anti-mycobacterial defense by producing protease-sensitive bioactive molecules and modulating macrophage autophagy-related pathways. These findings support further investigation of respiratory commensal-derived products as potential host-directed anti-TB strategies.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1052"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centralised management of Barrett's oesophagus surveillance: assessing progression risk and management.","authors":"Nicola B Raftery, Cian Muldoon, Ciara Ryan, Jacintha O'Sullivan, Dermot O'Toole, John V Reynolds, Jessie A Elliott","doi":"10.21037/jtd-2026-2204","DOIUrl":"https://doi.org/10.21037/jtd-2026-2204","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1071"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pretreatment prediction of early severe treatment-related toxicity in older patients with lung adenocarcinoma: same-center temporal validation of a risk model.","authors":"Huiying Sun, Xiao Chen, Jiexin Feng, Xiao Chen","doi":"10.21037/jtd-2026-1930","DOIUrl":"https://doi.org/10.21037/jtd-2026-1930","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Older adults with lung adenocarcinoma have heterogeneous tolerance of chemotherapy-based treatment. Early severe toxicity can disrupt planned therapy, require unplanned admission, and limit treatment intensity. We developed a pretreatment risk model for severe treatment-related toxicity within the first two chemotherapy-based cycles and examined whether Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) category and inflammatory-nutritional markers add risk-stratification information.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center retrospective cohort included patients aged ≥60 years with pathologically confirmed lung adenocarcinoma who received cytotoxic chemotherapy-based systemic treatment between September 2015 and September 2025. Among 1,106 screened patients, 1,019 formed the primary complete-case cohort; a multiple-imputation sensitivity analysis included 1,045 patients with eligible treatment exposure and adjudicable outcomes. Patients treated from September 2015 to December 2021 formed the development cohort (n=679), and those treated from January 2022 to September 2025 formed the same-center temporal validation cohort (n=340). The endpoint was Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 grade ≥3 treatment-related toxicity within the first two cycles. Model A contained clinical variables, Model B added FRAIL category, and Model C additionally incorporated the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI). Performance was assessed using discrimination, calibration, Brier score, decision curve analysis, and risk grouping.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Severe treatment-related toxicity occurred in 316 of 1,019 patients (31.0%): 202 in the development cohort and 114 in the validation cohort. Toxicity rates increased across FRAIL categories: 13.5% in robust, 28.5% in pre-frail, and 51.4% in frail patients (P for trend &lt;0.001). In Model C, frailty, higher Eastern Cooperative Oncology Group (ECOG) performance status, tumor-node-metastasis (TNM) stage IV disease, and lower PNI indicated greater risk. Model C yielded an area under the receiver operating characteristic curve (AUC) of 0.770 [95% confidence interval (CI): 0.736-0.809] in development and 0.753 (95% CI: 0.700-0.805) in validation. In the validation cohort, the calibration intercept was 0.124 (95% CI: -0.194 to 0.442) and slope was 0.986 (95% CI: 0.706-1.267). Model C also produced ordered low-, intermediate-, and high-risk strata with increasing observed toxicity rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A pretreatment model combining clinical variables, FRAIL category, NLR, and PNI separated older patients with lung adenocarcinoma into different levels of early severe toxicity risk. The model showed moderate discrimination, acceptable calibration, and directionally consistent sensitivity analyses. It may support closer observation and supportive-care planning, but routine u","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1020"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing perioperative risks: impact of neoadjuvant therapy on mortality in pneumonectomy.","authors":"Christina S Boutros, Aria Bassiri, Boxiang Jiang, Jillian Sinopoli, Leonidas Tapias, Philip A Linden, Christopher W Towe","doi":"10.21037/jtd-2026-1175","DOIUrl":"https://doi.org/10.21037/jtd-2026-1175","url":null,"abstract":"<p><strong>Background: </strong>The INT0139 trial [2009] raised concerns about the safety of pneumonectomy after chemoradiation due to high perioperative mortality rates. Recent clinical trials have supported the use of neoadjuvant treatment as a viable option for stage Ib or greater lung cancer. We hypothesized that neoadjuvant treatment does not increase perioperative mortality risk in patients undergoing pneumonectomy.</p><p><strong>Methods: </strong>Adult patients with nonmetastatic non-small cell lung cancer (NSCLC) from the 2004-2021 National Cancer Database undergoing pneumonectomy were analyzed in a retrospective cohort study. Exclusions included missing study variables, non-adenocarcinoma/squamous histology and pneumonectomy after neoadjuvant radiation alone. Multivariate logistic regression analyzed 30- and 90-day mortality and included laterality and neoadjuvant treatment interactions.</p><p><strong>Results: </strong>Of 14,522 patients, 58.6% underwent right pneumonectomy and 41.4% underwent left pneumonectomy. Neoadjuvant treatment was received by 14.9% (systemic therapy alone: 1,008; systemic therapy + radiation: 1,156). The 90-day mortality was higher for right versus left pneumonectomy (17.2% <i>vs.</i> 9.8%, P<0.001). Neoadjuvant therapy was not associated with higher 90-day mortality compared to surgery alone (10.4% <i>vs.</i> 13%, P=0.04). Independent predictors of mortality included right-sided pneumonectomy [odds ratio (OR) =2.01, 95% confidence interval (CI): 1.78-2.28], advanced age (OR =1.05, 95% CI: 1.04-1.06), and Charlson-Deyo index ≥ 3 (OR =1.98, 95% CI: 1.53-2.57). Interaction analysis showed no increased risk with neoadjuvant therapy for either side.</p><p><strong>Conclusions: </strong>This analysis reiterates known elevated risk associated with right pneumonectomy but disputes the dogma that neoadjuvant treatment increases the risk of pneumonectomy, suggesting that neoadjuvant treatment is not a contraindication to receipt of pneumonectomy.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1044"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic accessibility and conduit passage after retrosternal <i>vs</i>. posterior mediastinal gastric conduit reconstruction following McKeown esophagectomy: a retrospective cohort study.","authors":"Yiming Yao, Dong Jiang, Yifan Shi","doi":"10.21037/jtd-2026-1615","DOIUrl":"https://doi.org/10.21037/jtd-2026-1615","url":null,"abstract":"<p><strong>Background: </strong>The optimal route for gastric-conduit reconstruction after McKeown esophagectomy remains uncertain. Previous comparisons have focused primarily on anastomotic leakage and pulmonary morbidity, whereas postoperative endoscopic accessibility and clinically evident conduit-passage disturbance have been less well characterized. We compared retrosternal (RS) and posterior mediastinal (PM) reconstruction, focusing on these functional outcomes.</p><p><strong>Methods: </strong>This single-center retrospective cohort included 37 patients treated by the same surgical team between March 2025 and April 2026 (RS, n=14; PM, n=23). Upper gastrointestinal contrast assessment was generally performed at approximately 2 weeks and routine postoperative endoscopy at approximately 3 weeks, unless endoscopy was contraindicated or not feasible. Endoscopy time and route-related difficulty were evaluated at the examination level. Clinically evident passage disturbance, defined as dysphagia with retained food or impaired bolus transit requiring endoscopic confirmation or treatment, was evaluated at the patient level during 3 months of follow-up. Early and late delayed gastric conduit emptying (DGCE) and secondary perioperative outcomes were also assessed. All comparisons were unadjusted and exploratory.</p><p><strong>Results: </strong>Among examinations with recorded duration (13 RS and 24 PM), median endoscopy time was longer after RS reconstruction [14.00 (8.00, 17.00) <i>vs.</i> 7.50 (6.00, 11.00) minutes, P=0.01]. Route-related difficulty in scope advancement or incomplete anastomotic visualization was documented in four RS examinations and in none of the 24 completed PM examinations. Four RS patients developed clinically evident passage disturbance with dysphagia and retained food, compared with no PM patients (4/14 <i>vs.</i> 0/23, P=0.02). All four events were associated with anastomotic stricture; retained food was removed endoscopically, followed by dilation in three patients and stent placement in one, and all subsequently resumed oral intake. Anastomotic stricture occurred in 4/14 RS and 1/23 PM patients (P=0.057). No statistically detectable between-group differences were observed for early DGCE (1/14 <i>vs.</i> 1/23; P>0.99), late DGCE (2/14 <i>vs.</i> 0/23; P=0.14), or anastomotic leakage (1/14 <i>vs.</i> 2/23; P>0.99).</p><p><strong>Conclusions: </strong>RS reconstruction was associated with longer examination-level endoscopy time and four stricture-related passage-disturbance events in this small cohort, whereas no statistically detectable route-related difference in DGCE was observed. These unadjusted findings are hypothesis-generating and do not establish the superiority of either route. Larger prospective studies incorporating standardized endoscopic assessment, route-geometry measures, validated dysphagia instruments, and longitudinal functional outcomes are warranted.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1045"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Air-Test for prediction of postoperative pulmonary complications after general anaesthesia: promise, performance and limitations.","authors":"Kate Gallagher, Itay Bentov","doi":"10.21037/jtd-2026-1731","DOIUrl":"https://doi.org/10.21037/jtd-2026-1731","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1077"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video-assisted thoracoscopic diaphragmatic plication in a ventilator-dependent patient with an elevated and dysfunctional hemidiaphragm.","authors":"Fangyuan Li, Chengqiang Li, Hecheng Li","doi":"10.21037/jtd-2026-1455","DOIUrl":"https://doi.org/10.21037/jtd-2026-1455","url":null,"abstract":"<p><p>Unilateral hemidiaphragm dysfunction can reduce ventilatory reserve, but its contribution to weaning failure is difficult to isolate in a critically ill patient. A 61-year-old woman with asthma and a chronically elevated left hemidiaphragm developed severe pneumonia and acute hypercapnic respiratory failure, with an arterial partial pressure of carbon dioxide (PaCO₂) of 164.9 millimeters of mercury (mmHg), followed by recurrent extubation failure and tracheostomy. Pulmonary embolism was excluded. Bronchoscopy, microbiological treatment, nutritional support, and treatment for suspected autoimmune disease improved several reversible problems, yet hypercapnia recurred during ventilator reduction. Prior imaging showed that the elevation predated the acute illness. Formal fluoroscopic sniff testing, diaphragm ultrasound, phrenic nerve studies, and complete ventilator-setting records were unavailable; the condition is therefore described cautiously as an elevated and dysfunctional hemidiaphragm, most consistent clinically with acquired paralysis rather than a true hernia. After multidisciplinary reassessment, three-port left video-assisted thoracoscopic diaphragmatic plication was performed under low-pressure capnothorax. The diaphragm was flattened with six rows of continuous nonabsorbable braided polyester suture, using repeated mattress-type bites reinforced with polytetrafluoroethylene pledgets. Operative time was 180 minutes. PaCO₂ was 36.0 mmHg on postoperative day 1. Spontaneous-breathing trials began on postoperative day 2, and sustained side-arm oxygen through the tracheostomy began on postoperative day 7. Hypercapnic acidosis recurred on postoperative days 11-12 during ongoing pulmonary infection. She was transferred for rehabilitation off the ventilator on postoperative day 15 and remained off ventilatory support at last contact, with the tracheostomy still in place. This case does not establish that plication alone produced ventilator liberation. It shows how a familiar operation may be used after cautious selection to remove one potentially reversible mechanical burden in multifactorial weaning failure.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1056"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why is there so much reluctance to use more crossbars in pectus surgery?","authors":"Miguel Lia Tedde","doi":"10.21037/jtd-2026-1977","DOIUrl":"https://doi.org/10.21037/jtd-2026-1977","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1066"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: multimodal biopsy in radial EBUS.","authors":"Taehoon Lee","doi":"10.21037/jtd-2026-2405","DOIUrl":"https://doi.org/10.21037/jtd-2026-2405","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1065"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with 30-day mortality in patients with post-myocardial infarction ventricular septal rupture: a retrospective cohort study.","authors":"Jiayi Guo, Kaiwen Xiao, Jiayi Shi, Chunxu Song, Nan Zhang, Jingtao Cao, Chao Liu","doi":"10.21037/jtd-2026-1814","DOIUrl":"https://doi.org/10.21037/jtd-2026-1814","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Post-myocardial infarction ventricular septal rupture (VSR) is associated with high mortality, and comparative outcome data across contemporary treatment strategies remain limited. We aimed to identify factors associated with 30-day mortality, compare observed outcomes across four treatment strategies, including surgical repair combining an occluder and a patch (SurCOP), and develop an internally validated multivariable model incorporating the treatment ultimately received for retrospective prognostic assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between May 2012 and October 2025, 214 patients with post-myocardial infarction VSR were included and classified according to 30-day survival status. Baseline characteristics, clinical presentations, and treatment strategies, including conservative medical therapy, transcatheter closure, traditional surgical repair, and SurCOP, were compared. Univariable and multivariable logistic regression analyses were performed to identify factors associated with 30-day mortality. The prognostic model was developed in a 187-patient complete-case cohort defined before variable selection. Model discrimination was assessed using receiver operating characteristic (ROC) curve analysis, and internal validation was performed using stratified 10-fold cross-validation and bootstrap optimism correction with 500 resamples.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 214 enrolled patients with VSR, the overall 30-day mortality rate was 51.9%. Notably, observed 30-day mortality was lowest in the SurCOP group (21.8%), although treatment-group comparisons should be interpreted in light of non-random treatment allocation. Among the 123 patients who underwent a definitive invasive intervention, the median interval from VSR diagnosis to treatment differed among the SurCOP, traditional surgical repair, and transcatheter closure groups (6.5, 31.4, and 17.8 days, respectively; P&lt;0.001). Multivariable logistic regression analysis revealed that conservative medical therapy was associated with a higher odds of mortality compared to the SurCOP technique [odds ratio (OR), 27.822]. Additionally, elevated admission creatinine (OR, 1.010) and lactate (OR, 1.337) were independently associated with higher 30-day mortality. Conversely, a history of angina pectoris or myocardial infarction (OR, 0.235) was independently associated with lower 30-day mortality. A retrospective prognostic model incorporating the treatment ultimately received was subsequently constructed. The model demonstrated good discriminatory performance, with an apparent area under the ROC curve (AUC) of 0.906 [95% confidence interval (CI): 0.863-0.948], a sensitivity of 0.768, and a specificity of 0.943. Stratified 10-fold cross-validation yielded an AUC of 0.875 (95% CI: 0.825-0.925), and the bootstrap optimism-corrected AUC was 0.884.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this retrospective single-center cohort, treatment modality, admission creatini","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1017"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}