Risk Factors of Severe Postoperative Complication in Lung Cancer Patients with Diabetes Mellitus.

Purpose: Clinically, postoperative complications are occasionally observed in lung cancer patients with diabetes mellitus (DM). The increased risk of postoperative complications in DM patients has been reported in other fields. This study aims to identify risk factors for severe postoperative complications in lung cancer patients with DM.

Methods: Of 2756 consecutive patients who underwent complete resection for lung cancer between 2008 and 2018 in our hospital, 475 patients (20%) were complicated by DM. Clinical factors and diabetic factors (HbA1c, preoperative fasting blood glucose [FBG], postoperative mean FBG on 1, 3 postoperative days [PODs], and use of insulin) were evaluated by univariable and multivariable analyses to identify independent risk factors of severe complication.

Results: The 349 (73%) patients were male. Their median age was 71 years. Severe perioperative complications occurred in 128 (27%) patients. In the multivariable analysis, male (p <0.01), age (≥75 years) (p = 0.04), preoperative FBG (≥140 mg/dL) (p = 0.03), and increased mean FBG on 1, 3 PODs (≥180 mg/dL) (p <0.01) were significantly associated with severe perioperative complications.

Conclusion: Increased FBG on 1, 3 PODs (≥180 mg/dL) was an independent risk factor for severe perioperative complications in lung cancer with DM. Postoperative hyperglycemia may be correlated to severe perioperative complications.