Predictive Value of the Advanced Lung Cancer Inflammation Index for the Postoperative Complications of Lung Resections in Patients with Bronchiectasis: A Retrospective Study Short Title : Study on the Correlation between the Advanced Lung Cancer Inflammation Index and Patients with Bronchiectasis

Abstract

Background: Bronchiectasis patients often suffer from systemic inflammation and malnutrition, which negatively affect their prognosis. The advanced lung cancer inflammation index (ALI) has emerged as a novel biomarker that reflects systemic inflammation and malnutrition. However, its utility in predicting postoperative complications in bronchiectasis patients undergoing localized surgical resection remains to be clarified. Method: This retrospective study included 160 patients with localized bronchiectasis who underwent a single lobectomy at our center from April 2012 to December 2022. The optimal ALI cutoff point was established using the receiver operating characteristic (ROC) curve. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for postoperative complications. Results: The optimal cutoff value for the ALI was determined to be 38.37. Compared to the high ALI group, the low ALI group exhibited a significantly greater incidence of open chest surgeries (P=0.001), increased duration of surgeries (P=0.024), greater intraoperative blood loss (P=0.016), prolonged postoperative chest tube drainage (P=0.001), extended hospital stays after the operation (P=0.001), and a greater rate of complications (P=0.006). Multivariate logistic regression analysis revealed that prolonged surgical duration, low body mass index (BMI), and low preoperative ALI were independent risk factors for postoperative complications. To predict the likelihood of these complications, we developed a nomogram incorporating these independent factors, which demonstrated predictive accuracy with an area under the curve (AUC) of 0.792. Conclusion: The preoperative ALI serves as an independent predictor of postoperative complications in patients with localized bronchiectasis who underwent a single lobectomy.