The strong risk factors for the development of postoperative complications were history of severe COPD (P = 0.031), dyspnea with minimal exertion (P = 0.041), being at least partially dependent (P = 0.041), smoking within the past year (P = 0.044), ASA class of more than 2 (P = 0.000), diabetes treated with insulin (P = 0.003), and steroid use for chronic condition (P = 0.003). Here, INS is linked to chronic obstructive pulmonary disease.