Body mass index as a predictor of postoperative complications after anatomical lung resection

Lung cancer is the leading cause of cancer-related mortality worldwide. Surgical resection remains the standard treatment for early stage non-small cell lung cancer (NSCLC). Postoperative complications significantly affect patient outcomes, and nutritional status has emerged as an important factor influencing surgical morbidity. Body mass index (BMI) is a practical and widely used indicator of nutritional status; however, its impact on postoperative outcomes after lung resection remains controversial.

BMI is a practical and widely used indicator of nutritional status; however, its impact on postoperative outcomes after lung resection remains controversial.

This retrospective study included patients who underwent anatomical lung resection with systematic lymph node dissection for NSCLC between 2018 and 2021. Patients were categorized according to BMI as having moderate nutritional status (BMI 18-25 kg/m²) or good nutritional status (BMI > 25 kg/m²). Statistical comparisons between groups were performed using appropriate parametric and non-parametric tests, with a p-value < 0.05 considered statistically significant.

A total of 172 patients were included in the analysis. Serum albumin levels were significantly higher in patients with good nutritional status (p = 0.027). Postoperative length of hospital stay was significantly longer in the moderate nutritional status group (p < 0.001). Additionally, postoperative complications and prolonged air leakage were significantly more frequent in patients with moderate nutritional status (p = 0.002, p = 0.009, respectively).

Patients with a good nutritional status demonstrated more favorable postoperative outcomes, including fewer complications, reduced incidence of prolonged air leakage, and shorter hospital stays. Higher serum albumin levels in this group suggest a protective effect of better nutritional reserves. These findings support the concept that nutritional status plays a critical role in postoperative recovery following lung cancer surgery. Although BMI is a simple and accessible tool, future studies incorporating detailed body composition analysis and standardized perioperative care protocols may further refine risk stratification and optimize outcomes in NSCLC patients.