Alcohol-related disorders are associated with short-term outcomes in lung cancer patients undergoing VATS lobectomy: a 5-year retrospective analysis.

BACKGROUND

Alcohol abuse/dependence has been associated with an increased risk of postoperative complications. This study aims to evaluate the impact of alcohol abuse/dependence on short-term surgical outcomes in lung cancer patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy.

METHODS

We analyzed data from the National Inpatient Sample (NIS) covering the years 2016 to 2020, focusing on 13,273 lung cancer patients who had undergone VATS lobectomy. Patients were categorized based on their history of alcohol abuse/dependence. A 1:2 nearest-neighbor propensity-score matching was performed to align the alcohol exposure group with control subjects. The study assessed several outcomes, including the incidence of short-term postoperative complications, in hospital mortality rates, length of stay, and overall hospital costs.

RESULTS

After matching, 333 patients with alcohol abuse/dependence were compared to 660 without. Patients with alcohol-related issues exhibited significant higher complication rates, including postoperative acute respiratory insufficiency (OR, 2.60; 95% CI, 1.63-4.13), pulmonary collapse ( OR, 1.72; 95% CI, 1.11-2.65), pneumonia ( OR, 4.77; 95% CI, 2.29-9.94), blood transfusion (OR, 3.06; 95% CI, 1.26-7.41), mechanical ventilation (OR, 3.05; 95% CI, 1.56-5.98), and sepsis/shock (OR, 8.50; 95% CI, 2.86-25.26). Furthermore, patients with alcohol abuse/dependence who underwent VATS lobectomy had significantly elevated hospital costs (P = 0.006) and a prolonged length of stay (P < 0.001). Trend analyses indicated a progressive increase in the incidence of various postoperative complications-including acute respiratory insufficiency, pulmonary collapse, pneumonia, supraventricular arrhythmias, gastrointestinal issues, blood transfusion requirements, mechanical ventilation, noninvasive ventilation, and sepsis/shock-correlating with the severity of alcohol abuse.

CONCLUSION

Our findings reveal the substantial effect of alcohol exposure on short-term outcomes for lung cancer patients undergoing VATS lobectomy. The adverse influences of alcohol abuse/dependence were particularly pronounced in this surgical context. These results emphasize the necessity for preoperative risk stratification in these high-risk patients.