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Association between diaphragm thickness and postoperative complications in elderly patients with non-small-cell lung

Shoji Kuriyama¹, Motoko Konno², Naoko Mori²

¹Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. syommf1u@gipc.akita-u.ac.jp.

|September 20, 2025

Abstract

Purpose:

Predicting perioperative complications in high-risk elderly patients with lung cancer has become increasingly important as the population ages. This study investigated the relationship between preoperative diaphragmatic thickness (DT) and perioperative complications.

Methods:

We enrolled 101 patients ≥ 75 years old who had undergone radical resection for primary lung cancer between 2013 and 2018. Bilateral DT was measured on axial and coronal computed tomography, and the mean DT (MDT) was calculated based on these measurements. Outcomes were assessed based on postoperative complications, defined as Clavien-Dindo classification ≥ 2.

Results:

The MDT was 3.51 ± 1.00 mm. Thirteen patients who experienced postoperative respiratory complications had a significantly lower MDT than a higher MDT (p = 0.0390). Multivariate logistic regression analyses revealed that an MDT ≤ 3.63 mm was an independent factor associated with postoperative complications (odds ratio, 5.559).

Conclusions:

Patients with a low MDT are at an increased risk of postoperative complications. Therefore, these patients require careful perioperative management.

Keywords:

Computed tomography Diaphragm Elderly patients Non-small-cell lung cancer Postoperative complications

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