Risk factors of postoperative complications after lung resections: a retrospective multiple-center study

Objective. To assess the incidence of postoperative complications and risk factors of specific adverse outcomes after lung resections in a multiple-center cohort. Material and methods. A retrospective study is based on a pooled database from four hospitals: oncology dispensaries in Ekaterinburg and Ulyanovsk, Tolyatti City Clinical Hospital No. 5 and Seredavin Samara Regional Clinical Hospital. There were 471 patients. The main outcomes were any postoperative complication, prolonged air leakage and prolonged pleural effusion. Prolonged air leak was defined as air leak persisting beyond 5 postoperative days; prolonged pleural effusion was defined as drainage output >100 ml/day after postoperative day 5 with complete lung expansion and no air leak. Results. Any postoperative complication occurred in 156 (33.1%) patients, prolonged air leak — in 62 (13.2%), prolonged pleural effusion - in 69 (14.6%). Male sex, combined resection and surgery time ≥150 min were independent factors for composite outcome. Male sex and bronchial asthma were independently associated with prolonged air leak. Bronchial asthma and COPD remained independently associated with prolonged pleural effusion. Conclusion. Risk factors differed depending on complication. This supports separate assessment of specific postoperative outcomes. The obtained models are exploratory and require external validation.