Postoperative pain score and infection risk in lung cancer resection: a propensity score-matching study

To explore the relationship between postoperative pain score and infection after lung cancer resection using propensity score matching.

A retrospective analysis was conducted on 206 cases of malignant lung tumors that underwent surgical resection between September 2022 and October 2025. Patients were divided into a low numerical rating scale (NRS) group (NRS ≤ 3, n = 134) and a high NRS group (NRS > 3, n = 72) based on their postoperative pain scores. A 1:1 propensity score matching was used to balance baseline characteristics, and postoperative pulmonary infection rates were compared.

Before matching, there were no significant differences between the low and high NRS groups in terms of gender, age, history of back pain, operation time, incision intercostal width, length of hospital stay, and preoperative psychological status (all P < 0.05). After matching, there were no statistically significant differences in these indicators between the two groups (all P > 0.05). The postoperative pulmonary infection rate in patients with low NRS scores was 4.88%, lower than the 24.39% in patients with high NRS scores (P < 0.05). The visual analog scale (VAS) scores of both groups were significantly lower than those of the high NRS group at 2, 6, and 12 hours postoperatively (all P < 0.05), while the overall complication rate was significantly lower in the high-score group (P < 0.05). The forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal voluntary ventilation (MVV) levels were significantly lower in the low-score group than those in the high-score group (all P < 0.05).

There is a certain correlation between postoperative pain score and pulmonary infection after lung cancer resection.