Risk factors of cough in non-small cell lung cancer patients after video-assisted thoracoscopic surgery

Rongjia Lin, Guowei Che


Background: Cough is a common respiratory complication in non-small cell lung cancer (NSCLC) patients after surgery. Previous studies have proposed a number of risk factors for postoperative cough; however, these studies are mainly based on traditional thoracotomies and tend to lack adequate objective assessment methods. The purpose of this study was to identify the risk factors of cough in NSCLC patients after video-assisted thoracoscopic surgery (VATS) using the Leicester Cough Questionnaire in Mandarin Chinese (LCQ-MC) to evaluate postoperative cough.
Methods: A total of 198 NSCLC patients were enrolled. Overall, 91 patients (46.0%) developed cough after VATS, and 73 patients remained cough after 1 month. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors of postoperative cough.
Results: The independent factors of postoperative cough included female sex [odds ratio (OR) 2.399, 95% confidence interval (CI): 1.260–4.565, P=0.008], duration of anesthesia (over 164 minutes; OR 2.810, 95% CI: 1.368–5.771, P=0.005), resection of the lower paratracheal nodes (OR 3.697, 95% CI: 1.439–9.499, P=0.007), and resection of the subcarinal nodes (OR 4.175, 95% CI: 1.203–14.495, P=0.024). The follow-up LCQ-MC total score after 1 month (18.00±1.80) was significantly higher than the postoperative total score (16.35±2.26; P=0.004).
Conclusions: Female sex, duration of anesthesia over 164 minutes, lower paratracheal node resection and subcarinal node resection were independent risk factors related to cough in NSCLC patients after VATS. In addition, the LCQ-MC performed satisfactorily in describing the longitudinal changes in cough symptoms.