Predictors of Prolonged Hospital Stay in Patients with Lung Cancer Undergoing Sublobar Resection

Background:Sublobar resection (SLR) has become the standard treatment for patients with peripheral early-stage non-small cell lung cancer (NSCLC). Identifying the risk factors contributing to prolonged length of stay (LOS) after SLR is critical to improving surgical service efficiency. This study aimed to identify the predictors of prolonged LOS in patients with NSCLC who have undergone SLR. Methods:This retrospective study included consecutive patients with NSCLC who underwent SLR between 2011 and 2021 at West China Hospital. The primary outcome was the association between clinicopathological factors and prolonged LOS (defined as an LOS exceeding the median LOS). Multivariate logistic regression analysis was performed to identify the predictors of prolonged LOS. Results:Overall, 4,173 patients were included in the study (wedge resection: n=1,287; segmentectomy: n=2,886). The median postoperative LOS was 3 and 4 days in the wedge resection and segmentectomy groups, respectively. Advanced age, male sex, symptoms at presentation, larger size of the main lesion, and longer operative time were significantly associated with prolonged LOS in both the wedge and segmentectomy groups. A higher percent predicted forced expiratory volume in the first second was a protective factor for prolonged LOS after SLR, whereas a higher percent predicted diffusion capacity for carbon monoxide was a protective factor specifically for segmentectomy. Conclusions:Male sex, advanced age, symptoms at presentation, larger main lesion size, longer operative time, and impaired lung function were risk factors for a prolonged LOS after SLR. Candidates for SLR with these risk factors require heightened attention during clinical planning and postoperative management.