Male Sex, Early Postoperative C-Reactive Protein and Prolonged Hospital Stay After Lung Resection in Older Patients: A Retrospective Cohort Study.
- 1College of Life Sciences and Biotechnology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.
- 2Ewha Medical Research Institute, School of Medicine, Ewha Womans University, Seoul 03760, Republic of Korea.
- 3Ewha Medical Artificial Intelligence Center, School of Medicine, Ewha Womans University, Seoul 03760, Republic of Korea.
Abstract
Background/objectives
Older patients make up a growing share of the lung-resection workload, and C-reactive protein measured in the first days after operation is used to judge recovery. Whether the same concentration means the same thing in older men and older women is not established.Methods
We analysed 724 lung resections in 716 patients from VitalDB, an open perioperative dataset from a Korean tertiary hospital; 313 (43.2%) were aged 65 years or older. The primary outcome was a postoperative stay of 7 days or longer. Older general surgical patients from the same institution served as an age-matched negative control.Results
Among patients aged 65 or older, prolonged stay occurred in 55 of 192 men (28.6%) and 10 of 121 women (8.3%), adjusted odds ratio 3.031 (95% CI 1.425-6.446, p = 0.0040). Median day 1 C-reactive protein was 51.9 mg/L in older men and 27.4 mg/L in older women, adjusted ratio of geometric means 1.825 (1.593-2.090, p = 1.8 × 10⁻¹⁶). C-reactive protein predicted prolonged stay unadjusted (1.594 per doubling, 1.292-1.967) but not once sex entered the model (0.865, 0.691-1.084, p = 0.208), an interval that remains compatible with a modest association in either direction. In 1635 older general surgical patients, neither effect was present (0.863, p = 0.302; 1.238, p = 0.163). The sex-by-age interaction was not significant (p = 0.519).Conclusions
In older patients undergoing lung resection, men mount a larger early inflammatory response than women to comparable operations and are three times as likely to stay a week or longer, an association absent from older general surgical patients at the same institution. In this dataset and with the measured covariates, C-reactive protein on the first postoperative day was not independently associated with prolonged hospital stay after adjustment for sex and the other available factors; with 113 events, this does not establish absence of prognostic value. These data do not derive, validate, or justify sex-specific C-reactive protein thresholds, and none is proposed.
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BibTeX
@article{kim2026male,
title = {{Male Sex, Early Postoperative C-Reactive Protein and Prolonged Hospital Stay After Lung Resection in Older Patients: A Retrospective Cohort Study.}},
author = {Yeon Soo Kim and So Hyun Ahn},
journal = {Diseases (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/diseases14100369},
url = {https://europepmc.org/article/MED/42929996},
note = {CC BY},
}
RIS
TY - JOUR
TI - Male Sex, Early Postoperative C-Reactive Protein and Prolonged Hospital Stay After Lung Resection in Older Patients: A Retrospective Cohort Study.
AU - Yeon Soo Kim
AU - So Hyun Ahn
PY - 2026
DA - 2026/10/06
JO - Diseases (Basel, Switzerland)
DO - 10.3390/diseases14100369
UR - https://europepmc.org/article/MED/42929996
AB - Background/objectives Older patients make up a growing share of the lung-resection workload, and C-reactive protein measured in the first days after operation is used to judge recovery. Whether the same concentration means the same thing in older men and older women is not established.Methods We analysed 724 lung resections in 716 patients from VitalDB, an open perioperative dataset from a Korean tertiary hospital; 313 (43.2%) were aged 65 years or older. The primary outcome was a postoperative stay of 7 days or longer. Older general surgical patients from the same institution served as an age-matched negative control.Results Among patients aged 65 or older, prolonged stay occurred in 55 of 192 men (28.6%) and 10 of 121 women (8.3%), adjusted odds ratio 3.031 (95% CI 1.425-6.446, p = 0.0040). Median day 1 C-reactive protein was 51.9 mg/L in older men and 27.4 mg/L in older women, adjusted ratio of geometric means 1.825 (1.593-2.090, p = 1.8 × 10⁻¹⁶). C-reactive protein predicted prolonged stay unadjusted (1.594 per doubling, 1.292-1.967) but not once sex entered the model (0.865, 0.691-1.084, p = 0.208), an interval that remains compatible with a modest association in either direction. In 1635 older general surgical patients, neither effect was present (0.863, p = 0.302; 1.238, p = 0.163). The sex-by-age interaction was not significant (p = 0.519).Conclusions In older patients undergoing lung resection, men mount a larger early inflammatory response than women to comparable operations and are three times as likely to stay a week or longer, an association absent from older general surgical patients at the same institution. In this dataset and with the measured covariates, C-reactive protein on the first postoperative day was not independently associated with prolonged hospital stay after adjustment for sex and the other available factors; with 113 events, this does not establish absence of prognostic value. These data do not derive, validate, or justify sex-specific C-reactive protein thresholds, and none is proposed.
SN - 2079-9721
ER -