Abstract: Objective To analyze the incidence and risk factors of postoperative pulmonary complications (PPCs) in elderly patients undergoing video-assisted thoracoscopic surgery(VATS). Methods Elderly patients aged≥65 years who underwent VATS in Peking Union Medical College Hospital from January 2013 to December 2017, were reviewed retrospectively and divided into non-PPCs group and PPCs group. General information, past medical history, and postoperative complications were recorded in a uniform case report form. The clinical factors with statistical significance in univariate analysis and important clinical significance according to experience were analyzed with Logistic regression to evaluate the independent risk factors for PPCs. Results A total of 900 patients were included, and 48(5.3%) of them suffered PPCs. Multivariate logistic regression showed that pre-operative smoking history,history of stroke, chronic obstructive pulmonary disease (COPD) and pulmonary lobectomy were independent risk factors for PPCs in elderly patients after VATS. Conclusions Elderly patient is a high-risk group for PPCs after VATS. The risk factors include smoking history, stroke, COPD and scope of surgery. Therefore, perioperative management needs to optimize, and monitoring should be strengthened for these high-risk patients.

Key words: elderly patients, video-assisted thoracoscopic surgery(VATS), postoperative pulmonary complications, risk factors