Effect of Type 2 Diabetes on the Development of Acute Respiratory Distress Syndrome (ARDS) in Patients with Lung Cancer After Surgery and Its Prognosis

Figures & data

Figure 1 Flow chart of patient selection.

Table 1 Baseline Data of Included Patients in Two Groups

Item (N, %)/(Mean±SD)	ARDS Group	Non-ARDS Group	t/X^2	p
Age (year)	65.69±9.76	65.47±9.81	0.162	0.871
Gender
Male	21(39.6%)	246(51.6%)	2.725	0.099
Female	32(60.4%)	231(48.3%)
BMI (kg/m^2)	22.47±2.90	22.27±2.95	0.585	0.559
TNM staging
I	15(28.3%)	145(30.4%)	1.071	0.784
II	22(41.5%)	190(39.8%)
III	13(24.5%)	127(26.6%)
IV	3(5.7%)	15(3.1%)
Pathology type
Adenocarcinoma	30(56.6%)	268(56.2%)	1.489	0.475
Squamous cell carcinoma	20(37.7%)	158(33.1%)
Other carcinoma	3(5.7%)	51(10.7%)
With diabetes or not
Yes	13(24.5%)	41(8.6%)	13.233	<0.001
No	40(75.5%)	436(91.4%)
With smoking or not
Yes	39(73.6%)	311(65.2%)	1.496	0.221
No	14(26.4%)	166(34.8%)
With chemotherapy or not
Yes	32(60.4%)	216(46.2%)	3.862	0.049
No	21(39.6%)	252(53.8%)
With respiratory basic diseases or not
Yes	22(41.5%)	226(47.4%)	9.494	0.009
No	31(56.6%)	251(52.6%)
With cardiac insufficiency or not
Yes	25(47.2%)	233(48.8%)	0.054	0.817
No	28(52.8%)	244(51.2%)
With electrolyte disturbances or not
Yes	20(37.7%)	120(25.2%)	3.883	0.049
No	33(62.3%)	357(74.8%)
Surgical method
Traditional thoracotomy	29(54.7%)	141(29.6%)	13.856	<0.001
Thoracoscopic surgery	24(45.3%)	336(70.4%)

Abbreviations: BMI, Body Mass Index; TNM, Tumor Node Metastasis; ARDS, acute respiratory distress syndrome; SD, Standard Deviation.

Table 2 Perioperative Indicators in Two Groups

Item (Mean±SD)	ARDS Group	Non-ARDS Group	t	p
Operative time	160.96±10.55	135.54±14.14	16.01	<0.001
Intraoperative blood loss	259.96±25.17	247.92±28.47	2.952	0.003
Crystalloid requirements	2669.28±273.00	2002.01±288.90	16.037	<0.001

Abbreviations: ARDS, acute respiratory distress syndrome; SD, Standard Deviation.

Table 3 Laboratory Indices of Patients in Two Groups

Item (Mean±SD)	FPG (mmol/L)	TG (mmol/L)	HDL-C (mmol/L)	ALb (g/L)	CEA (ng/mL)	WBC (×10^9/L)
						Preoperative	Postoperative
ARDS group	6.47±1.92	1.67±0.44	1.14±0.18	43.55±4.72	34.51±5.63	6.53±0.77	14.92±1.23
Non-ARDS group	5.83±1.41	1.69±0.28	1.13±0.18	43.86±5.05	34.27±5.86	6.72±0.76	12.45±1.50
t	2.327	6.222	0.193	−0.429	0.283	−1.782	13.615
p	0.023	<0.001	0.847	0.668	0.777	0.075	<0.001

Abbreviations: FPG, fasting plasma glucose; TG, Triglyceride; HDL-C, High density lipoprotein cholesterol; Alb, Albumin; CEA, carcinoembryonic antigen; WBC, White blood cells; ARDS, acute respiratory distress syndrome; SD, Standard Deviation.

Table 4 Comparison of the Lung Function Indexes Between the Two Groups

Item (Mean±SD)	ARDS Group (%)	Non-ARDS Group(%)	t/X^2	p
FEV1%	61.15±4.97	75.74±4.26	−23.252	<0.001
DLCO%	65.94±4.74	73.57±4.24	−12.282	<0.001

Abbreviations: FEV1, Forced expiratory volume one second; DLCO, carbon monoxide diffusing capacity; ARDS, acute respiratory distress syndrome; SD, Standard Deviation.

Table 5 Prognosis Assessment After Surgery in Patients in Two Groups

Item N (%)/(Mean±SD)	APACHEII Score	LIPS Score	SOFA Score
ARDS group	19.19±3.17	4.15±1.21	11.23±2.06
Non-ARDS group	0.04±3.17	2.05±1.18	4.96±2.56
t/X^2	19.917	12.266	20.428
p	<0.001	<0.001	<0.001

Abbreviations: APACHEII, Acute Physiology and Chronic Health EvaluationII; LIPS, lung injury prediction score; SOFA, Sequential Organ Failure Assessment; ARDS, acute respiratory distress syndrome; SD, Standard Deviation.

Table 6 Risk Factors of Recurrence Analyzed by Binary Logistic Regression Models

Item	B	SE	Wald	p	OR	95% CI
						Lower	Upper
With diabetes or not	1.358	0.385	12.433	<0.001	3.888	1.828	8.270
With chemotherapy or not	0.712	0.316	5.081	0.024	2.039	1.097	3.787
With respiratory basic diseases or not	−0.112	0.307	0.132	0.716	0.894	0.490	1.632
With electrolyte disturbances or not	0.609	0.321	3.606	0.058	1.839	0.981	3.451
Surgical method	0.924	0.304	9.226	0.002	2.521	1.388	4.577
Operative time	0.417	0.204	4.156	0.041	1.517	1.016	2.265
Intraoperative blood loss	0.053	0.032	2.715	0.099	1.054	0.990	1.123
Crystalloid requirements	0.016	0.005	8.579	0.003	1.016	1.005	1.027
FPG(mmol/L)	−0.578	0.879	0.433	0.511	0.561	0.100	3.143
WBC(×10^9/L)	3.563	1.683	4.482	0.034	35.265	1.303	954.674
FEV1%	−1.534	0.503	9.302	0.002	0.216	0.080	0.578
DLCO%	−0.925	0.354	6.820	0.009	0.397	0.198	0.794

Abbreviations: FPG, fasting plasma glucose; WBC, White blood cells; FEV1, Forced expiratory volume one second; DLCO, carbon monoxide diffusing capacity; SE, standard error; OR, odds ratio; CI, confidence interval.

Figure 2 Risk factors of recurrence analyzed by binary logistic regression models.

Table 7 Survival-Related Prognostic Factors in Cox Risk Regression Analysis for All Patients

Item	B	SE	Wald	p	OR
With diabetes or not	0.328	0.159	4.252	0.39	1.389
With ARDS or not	0.707	0.339	4.359	0.037	2.028
With chemotherapy or not	0.007	0.092	0.006	0.937	1.007
Crystalloid requirements	0.000	0.000	0.379	0.538	1.000
WBC	−0.009	0.031	0.082	0.774	0.991
FEV1%	−0.002	0.394	0.209	0.647	1.197
DLCO%	−0.004	0.513	0.048	0.827	1.119
LIPS score	−0.002	0.393	0.072	0.788	0.900
APACHE II score	1.459	0.356	16.755	0.000	4.300
SOFA score	0.785	0.852	0.850	0.357	2.193
Surgical method	−0.036	0.102	0.123	0.725	0.965

Abbreviations: ARDS, acute respiratory distress syndrome; WBC, White blood cells; FEV1, Forced expiratory volume one second; DLCO, carbon monoxide diffusing capacity; APACHEII, Acute Physiology and Chronic Health EvaluationII; LIPS, lung injury prediction score; SOFA, Sequential Organ Failure Assessment; SE, standard error; OR, odds ratio.