Objective: Postoperative Pulmonary Complications (PPCs) can contribute to increased mortality and
prolonged hospital stay in surgical patients with Gastric Cancer (GC). This study aimed to investigate potential
risk factors for PPCs in elderly GC patients following elective laparoscopic gastrectomy.
Methods: Eligible consecutive elderly GC patients (aged over 65 years) who were scheduled to undergo elective
laparoscopic gastrectomy were enrolled in this study. The demographic, clinicopathological characteristics and
laboratory variables were compared in patients with or without PPCs within postoperative 30 days. Risk factors
for PPCs were analyzed by multiple logistic regression analysis and receiver operating characteristic (ROC) curve
Results: 35 of all the 262 enrolled patients have developed PPCs with an incidence of 13.4%. Age, chronic obstructive
pulmonary disease (COPD), congestive heart failure (CHF), forced expiratory volume in one second/
forced vital capacity (FEV1/FVC) ratio, duration of operation, hemoglobin, albumin and C-reactive protein
(CRP) were potential risk factors for PPCs by univariate analysis. The preoperative albumin level was the only
independent risk factor for PPCs (OR: 1.15, 95%CI: 1.06-1.28, P=0.011) by multiple logistic regression analysis.
Preoperative albumin level was a predictor for PPCs with an area under the curve (AUC) of 0.728 and a cut-off
value of 33.8 mg/dl (specificity: 54.19%, sensitivity: 77.14%, P<0.001).
Conclusions: Preoperative albumin level was an independent risk factor for PPCs in elderly GC patients after
elective laparoscopic gastrectomy.