This study aimed to predict different physical activity (PA) levels in patients undergoing thoracoscopic lung resection surgery (LRS) using the International Physical Activity Questionnaire (IPAQ) and investigate the association between the PA levels and the incidence of postoperative pulmonary complications (PPCs). The patients were classified into the high-level and low-level PA groups based on the IPAQ scores. The incidence of PPCs within postoperative 5 days, number of PPCs, the incidence of postoperative adverse events (PAEs) within postoperative 5 days, extubation time, length of hospital stay (LOS), unplanned admission to the intensive care unit (ICU), and the mortality 1-month postoperatively were recorded. Arterial blood samples were collected before induction of anesthesia and 1 hour postoperatively, and the supernatants were centrifuged for cytokine analysis. Binomial logistic analysis was performed to determine the relationship between predefined variables and PPCs. Receiver operating characteristic (ROC) curve analysis was performed to identify independent risk factors, and the area under the curve (AUC) was calculated.

Inclusion Criteria:

1. Patients older than 18 years and younger than 80 years;
2. Patients scheduled to accept elective thoracic surgery under general anesthesia;
3. Patients of American Society of Anesthesiologists (ASA) Ⅱ～Ⅲ level grade;
4. Patients signed the informed consent form for the clinical study.

Exclusion Criteria:

1. Patients with moderate or severe chronic obstructive pulmonary disease (GOLD Grade III or IV level grade)；
2. Patients with severe or uncontrolled bronchial asthma；
3. Patients with severe neuromuscular disease or thoracic malformation；
4. Patients with severe heart disease (New York Heart Association Class III or IV level grade or acute coronary syndrome or persistent ventricular arrhythmia)；
5. Patients with cognitive dysfunction；
6. Patients who have participated in other clinical trials within the previous 30 days；
7. Patients with coagulation dysfunction；
8. Patients who received radiotherapy or chemotherapy within 2 months before surgery.

Patients aged 18~80 years undergoing elective thoracoscopic lung resection surgery under general anesthesia