What is the clinical evidence from this study?

Study design: Cohort. Population: Lung cancer (n=328). Intervention: Comorbidities (COPD, CAD, dyslipidemia) vs. Absence of comorbidities. Primary outcome: Postoperative pulmonary complications (per additional comorbidity) (aOR 1.4, p=0.02).

What question did this study set out to answer?

This study aims to evaluate the impact of cardiac, pulmonary, and metabolic comorbidities on postoperative pulmonary complications after lung cancer surgery.

April 28, 2026Journal of Cardiothoracic Surgery1 citationsOpen Access

Comorbidities as predictors of postoperative pulmonary complications after lung cancer surgery

FCFatmir Caushi ETEritjan Tashi ADAdela Dhimitri

Key Result

Each additional comorbidity increased the odds of postoperative pulmonary complications by 40% (aOR 1.4) in patients undergoing lung cancer surgery.

Key Points

This study aims to evaluate the impact of cardiac, pulmonary, and metabolic comorbidities on postoperative pulmonary complications after lung cancer surgery.
Retrospective cohort analysis of 328 lung cancer patients undergoing surgery between 2018–2024.
Evaluated comorbidities, age, sex, BMI, and pulmonary-function tests.
Used logistic regression models to estimate odds ratios for predictors of postoperative complications.
Postoperative pulmonary complications occurred in 29.6% (97/328) of patients.
COPD (aOR 2.8, 95% CI 1.4–5.4), CAD (aOR 2.3, 95% CI 1.1–4.9), and dyslipidemia (aOR 2.6, 95% CI 1.1–6.1) were identified as independent predictors.
A comorbidity-burden score indicated a 40% increase in odds of complications per additional comorbidity (aOR 1.4 per point, p = 0.02).

Study Design

Type

Cohort (n=328)

Multicenter

Structured PICO

Do cardiac, pulmonary, and metabolic comorbidities predict postoperative pulmonary complications in patients undergoing lung-cancer resection?

Population

328 patients who underwent lung-cancer resection, mean age 66 years, 84.8% male. Key comorbidities included COPD (42.1%), hypertension (48.8%), and coronary artery disease (9.1%).

Intervention

Lung cancer surgery (lobectomy, pneumonectomy, bilobectomy, or limited resection) via postero-lateral thoracotomy

Outcome

Any postoperative pulmonary complication (PPC) within 30 days post-operation, defined as pneumonia, respiratory insufficiency, pneumothorax, myocardial infarction, empyema, bronchopleural fistula, in-hospital death, or 30-day mortalitycomposite

Cardiac, pulmonary, and metabolic comorbidities, particularly COPD, coronary artery disease, and dyslipidemia, independently predict a higher risk of postoperative pulmonary complications after lung cancer surgery.

Main Result

Effect estimate: aOR 1.4

p-value: p=0.02

Limitations

Single-center retrospective design
Selection bias due to the lack of minimally invasive surgery
Incomplete physiological or nutritional data, such as the lack of DLCO testing
Limited statistical power for rare events like arrhythmia and empyema

Abstract

Lung surgery remains the cornerstone of curative treatment for lung cancer, providing the best long-term survival in resectable disease. Advances in operative techniques and perioperative management have made it a safe and effective procedure, even in elderly or comorbid patients. Nevertheless, postoperative pulmonary complications (PPCs) remain a major source of morbidity and mortality. While surgical magnitude and functional capacity are recognised determinants, the contribution of comorbidities has not been adequately quantified. This study evaluated the relationship between cardiac, pulmonary, and metabolic comorbidities and postoperative complications in patients undergoing lung-cancer resection. A retrospective cohort of 328 patients who underwent lung-cancer surgery during 2018–2024 was analysed. Variables included age, sex, BMI, pulmonary-function tests, and comorbidities chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD), dyslipidemia, hypertension, diabetes, smoking, chronic renal disease. Logistic-regression models estimated odds ratios and adjusted ORs for predictors of any PPC. PPCs occurred in 97/328 patients (29. 6%). Univariate analysis identified COPD, CAD, and dyslipidemia as significant predictors (p < 0. 05). In multivariable analysis adjusted for age, sex, BMI, and FEV1/FVC, COPD (aOR 2. 8, 95% CI 1. 4–5. 4), CAD (aOR 2. 3, 95% CI 1. 1–4. 9), and dyslipidemia (aOR 2. 6, 95% CI 1. 1–6. 1) remained independent predictors of complications. A comorbidity-burden score showed a 40% increase in odds of PPCs per additional comorbidity (aOR 1. 4 per point, p = 0. 02). Lung cancer surgery is a safe procedure however it has to be performed in properly selected patients due to risk of complications. Cardiac, pulmonary, and metabolic comorbidities—particularly COPD, coronary artery disease, and dyslipidemia—are independent predictors of postoperative pulmonary complications. Comprehensive preoperative evaluation and optimisation of these comorbidities are essential to minimise perioperative risk and improve outcomes after lung-cancer resection.

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Cite This Study

Caushi et al. (Sat,) conducted a cohort in Lung cancer (n=328). Comorbidities (COPD, CAD, dyslipidemia) vs. Absence of comorbidities was evaluated on Postoperative pulmonary complications (per additional comorbidity) (aOR 1.4, p=0.02). Each additional comorbidity increased the odds of postoperative pulmonary complications by 40% (aOR 1.4) in patients undergoing lung cancer surgery.

synapsesocial.com/papers/69f04e08727298f751e71fe9 https://doi.org/https://doi.org/10.1186/s13019-026-04229-z

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