Background Obesity is a significant risk factor for adverse postoperative outcomes, including impaired wound healing. This study aimed to investigate the association between the Body Roundness Index (BRI) and impaired wound healing following thoracic surgery.

Methods This study included 387 patients who underwent thoracic surgery at Tongji Hospital in Wuhan between October 2024 and January 2025. Wound healing was assessed 30 days postoperatively. Logistic regression and propensity score matching (PSM) analyses were performed to evaluate the relationship between BRI and impaired wound healing, with subgroup analyses conducted to further explore this association.

This prospective cohort study collected clinical data from patients undergoing thoracic surgery at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, between October 1, 2024, and January 30, 2025. Initial enrollment included 422 patients, with 387 participants retained after data cleaning (Figure 1). The primary objective was to evaluate the association between BRI and impaired postoperative wound healing through multivariable logistic regression, propensity score matching (PSM), and subgroup analyses.

Inclusion Criteria：

• Patients who underwent surgical treatment in the Department of Thoracic Surgery at Tongji Hospital;
• Complete clinical data and diagnostic test results available;
• Postoperative follow-up conducted regularly in accordance with medical advice, with comprehensive follow-up records；

Exclusion Criteria:

• Without surgery or transferred to other departments；
• Missing basic information；
• Failure to review on time or refusal to follow up；
• Additional surgeries within 30 days of discharge from the hospital；

This prospective cohort study collected clinical data from patients undergoing thoracic surgery at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, between October 1, 2024, and January 30, 2025. Initial enrollment included 422 patients, with 387 participants retained after data cleaning.