International Journal of General Medicine (Oct 2023)
Effect of Type 2 Diabetes on the Development of Acute Respiratory Distress Syndrome (ARDS) in Patients with Lung Cancer After Surgery and Its Prognosis
Abstract
Liang Zhang,1 Lanjun Guan,2 Xiaoyue Tang,2 Yong Zhao3 1Department of Endocrinology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China; 2Department of Internal Medicine, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China; 3Department of Thoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of ChinaCorrespondence: Yong Zhao, Department of Thoracic Surgery, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Wuxi, 214000, People’s Republic of China, Email [email protected]: Type 2 diabetes mellitus (T2DM) is associated with the occurrence of lung cancer. Postoperative lung cancer complications with acute respiratory distress syndrome (ARDS) are characterized by rapid onset and severe disease. This study aimed to analyze the effect of T2DM on the occurrence of ARDS in patients with lung cancer after surgery and its prognosis and further investigate the risk factors of postoperative complications of ARDS.Methods: A total of 530 patients who developed lung cancer from December 2016 to December 2021 were retrospectively analyzed. The t- and chi-square tests were used to determine the relationship between whether the patients had combined diabetes and other clinical characteristics. Binary logistic and Cox risk regressions were used to analyze the independent risk factors for the development of ARDS in patients after surgery and the effect of each factor on the survival status of patients, respectively.Results: Fifty-three cases of ARDS occurred after lung cancer surgery, with an incidence of 10%. Binary logistic regression analysis demonstrated that the independent influencing factors that determined the occurrence of ARDS after surgery were the presence or absence of combined diabetes (odds ratio [OR] = 3.888, P< 0.001), history of radiotherapy (OR = 2.039, P = 0.024), surgery mode (OR = 2.521, P = 0.002), and so on. Moreover, Cox risk regression analysis demonstrated that the presence or absence of combined diabetes (OR = 1.389, P = 0.039) and occurrence of ARDS (OR = 2.028, P = 0.037) were independent influencing factors on the patient survival time.Conclusion: In lung cancer patients with T2DM, postoperative ARDS is more likely to occur, and both diabetes and postoperative ARDS are risk factors affecting the survival of patients with lung cancer. Preoperative and postoperative glycemic control and improved pulmonary ventilation should be enhanced to minimize the chance of ARDS.Plain Language Summary: This study initially clarified the effect of type 2 diabetes on the development of acute respiratory distress syndrome and its prognosis in lung cancer patients after surgery and other risk factors for the development of ARDS in lung cancer patients after surgery, which may provide a theoretical basis for the effective prevention and treatment of the risk of ARDS after surgery.Keywords: type 2 diabetes mellitus, lung cancer, acute respiratory distress syndrome, prognosis
