After additional adjustment for hypertension, type 2 diabetes, COPD, coronary heart disease, preoperative analgesic use, and preoperative hemoglobin and albumin (model 2), CSD remained associated with a higher transfusion rate (RR = 2.529, 95% CI 2.052–3.116, P < 0.001) and a longer PLOS (B = 1.492, 95% CI 1.290–1.694, P < 0.001; B′ = 0.188). Here, ALB is linked to chronic obstructive pulmonary disease.