{
  "abstract": "Background: Lung cancer remains the primary cause of cancer-related mortality worldwide. While prolonged operative duration is increasingly recognised as a modifier of surgical risk, its independent association with prolonged intensive care unit (ICU) stay for more than 24 h following thoracoscopic lobectomy remains inadequately quantified. This study evaluated the association between operative duration and prolonged ICU stay for more than 24 h, including underlying dose-response relationships.\n\nMethods: We performed a retrospective cohort study using the Informative Surgical Patient dataset for Innovative Research Environment (INSPIRE) database, analysing 2545 surgical cases diagnosed with malignant bronchial or lung neoplasms undergoing curative-intent thoracoscopic lobectomy (2011–2020). Multivariable logistic regression, a generalised additive model, and a two-piecewise linear regression model were employed to assess the effect of operative duration on prolonged ICU stay for more than 24 h, adjusting for potential confounders.\n\nResults: The cohort comprised 2545 surgical cases. After adjusting for potential confounders, operative duration demonstrated an independent association with prolonged ICU stay for more than 24 h (adjusted odds ratio [OR] = 1.2; 95% confidence interval [CI], 1.06–1.36; P = 0.004). A nonlinear relationship was identified, with an inflection point at 2.39 h. Below this threshold, the OR was 2.967 (95% CI, 1.995–4.414); above it, the OR was 0.802 (95% CI, 0.633–1.015).\n\nConclusion: Operative duration exhibits a nonlinear, time-dependent association with prolonged ICU stay for more than 24 h following thoracoscopic lobectomy in lung cancer patients, persisting after rigorous confounder adjustment. The identified threshold of 2.39 h provides an evidence-based benchmark for surgical quality improvement initiatives.\n\nTrial registration: The current secondary analysis was exempt from research registration. The INSPIRE dataset part was registered with ClinicalTrials.gov under the Unique Identifying Number (UIN) NCTO2914444 and is publicly available at https//clinicaltrials.gov/study/NCTO2914444.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13019-026-04498-8.",
  "abstract_shown": true,
  "affiliations": [
    "Department of General Practice, First Medical Center, Chinese PLA General Hospital, Beijing, China",
    "Department of General Practice, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yang Song"
    },
    {
      "affs": [
        0
      ],
      "name": "Peiyue Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qing Rong"
    },
    {
      "affs": [
        0
      ],
      "name": "Tingting Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhaoyang Deng"
    },
    {
      "affs": [
        1
      ],
      "name": "Mingzhi Shen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1e6f93ayda287.bib",
  "cited_by": 0,
  "doi": "10.1186/s13019-026-04498-8",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711718/",
  "id": "1e6f93ayda287",
  "issns": [
    "1749-8090"
  ],
  "landing_url": "https://doi.org/10.1186/s13019-026-04498-8",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2740|Lung Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7171807530",
  "pdf_url": null,
  "pmcid": "PMC13711718",
  "pmid": "42947212",
  "published": "2026-07-31",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/1e6f93ayda287.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:22:27Z",
      "native_id": "PMC13711718",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s13019-026-04498-8"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Lung Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Association between operative duration and prolonged intensive care unit stay for more than 24 h in lung cancer patients following thoracoscopic lobectomy: a retrospective cohort analysis",
  "title_text": "Association between operative duration and prolonged intensive care unit stay for more than 24 h in lung cancer patients following thoracoscopic lobectomy: a retrospective cohort analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:27Z",
  "url": "https://research.draconitic.com/paper/1e6f93ayda287",
  "venue": "Journal of Cardiothoracic Surgery",
  "versions": []
}