The Effects of Type 2 Diabetes on Postoperative Pneumonia in Patients with Video-Assisted Thoracoscopic Surgery: A Retrospective Cohort Study

Xue-e Su,1 Yu-Shen Yang,1 Shan-Hu Wu,1 Hai-Jun Weng,1 He-Fan He,1 Bao-Yuan Xie2 1Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, 362000, People’s Republic of China; 2Nursing Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, 362000, People’s Republic of ChinaCorrespondence: He-Fan He, Department of Anesthesiology, The Second Affiliated Hospital of Fujian Medical University, No.34 North Zhongshan Road, Quanzhou, Fujian Province, 362000, People’s Republic of China, Tel +86 15860905262, Email [email protected] Bao-Yuan Xie, Nursing Department, The Second Affiliated Hospital of Fujian Medical University, No.34 North Zhongshan Road, Quanzhou, Fujian Province, 362000, People’s Republic of China, Tel +86 18174689901, Email [email protected]: The aim of the study was to investigate the relationship between type 2 diabetes (T2DM) and postoperative pneumonia (POP) after video-assisted thoracoscopic surgery, and explore the risk factors involved in the prediction of postoperative pneumonia in patients with T2DM.Patients and Methods: A retrospective study was conducted on 476 inpatients with video-assisted thoracoscopic surgery (VATS) in The Second Hospital of Fujian Medical University between January 2019 and December 2023. Demographic information, clinical variables including surgical data and preoperative laboratory indices that potentially impact POP were included. Subgroup and logistic analysis were performed to demonstrate risk factors for POP in patients with T2DM.Results: The incidences of POP were higher in patients with T2DM than patients without this condition (T2DM 23.08% vs non-diabetes 10.54%, P< 0.001). Logistic analysis further demonstrated that T2DM [odds ratio (OR), 2.07, 95% confidence interval (CI), 1.13– 3.83] is an independent risk of POP after adjusting for sex, age, hospital stay, American Society of Anesthesiologists (ASA) score, and tumor location. Thereafter, the subgroup analysis demonstrated that patients with T2DM in the setting of male gender, positive P53 and chemoradiotherapy displayed a higher incidence rate of POP. Subsequent logistic analysis indicated that sex and tumor location were independently associated with POP in patients with T2DM.Conclusion: Patients with T2DM who underwent VATS display a higher incidence of POP than those without this disease. Additionally, male gender and tumor location were independent risk factor for POP in patients with T2DM. Thus, male patients with T2DM, perioperative management should be improved and optimized for patient safety.Keywords: type 2 diabetes, postoperative pneumonia, video-assisted thoracoscopic surgery