Variability in length of stay after uncomplicated pulmonary lobectomy: is length of stay a quality metric or a patient metric?†

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Greg P GiambroneBrendon M Stiles

Abstract

Previous studies have identified predictors of prolonged length of stay (LOS) following pulmonary lobectomy. LOS is typically described to have a direct relationship to postoperative complications. We sought to determine the LOS and factors associated with variability after uncomplicated pulmonary lobectomy. Analysing the State Inpatient Databases, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality database, we reviewed lobectomies performed (2009-11) on patients in California, Florida and New York. LOS and comorbidities were identified. Multivariable regression analysis (MVA) was used to determine factors associated with LOS greater than the median. Patients with postoperative complications or death were excluded. Among 22 647 lobectomies performed, we identified 13 099 patients (58%) with uncomplicated postoperative courses (mean age = 66 years; 56% female; 76% white, 57% Medicare; median DEYO comorbidity score = 3, 55% thoracotomy, 45% thoracoscopy/robotic). There was a wide distribution in LOS [median LOS = 5 days; interquartile range (IQR) 4-7]. By MVA, predictors of prolonged LOS included, age ≥ 75 years [odds ratio (OR) 1.7, 95% confidence interval (CI) 1.4-2.0], male gender (OR 1.2, 95% ...Continue Reading

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Citations

Mar 8, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Erik M von MeyenfeldtRonald A M Damhuis
Mar 16, 2019·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Guillaume S ChevrollierNathaniel R Evans
Jul 20, 2019·International nursing review·Y O OdejobiV Chittithavorn
Nov 5, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Erik M von MeyenfeldtHermien W H Schreurs
Oct 22, 2019·Diseases of the Colon and Rectum·Joceline Vuong-Thu VuScott E Regenbogen
Apr 12, 2018·American Journal of Clinical Oncology·Stephanie TuminelloRaja M Flores
Sep 19, 2019·Integrative Cancer Therapies·Marcus JonssonElisabeth Westerdahl
Feb 2, 2021·The Journal of Thoracic and Cardiovascular Surgery·John K PeelBiniam Kidane
Oct 14, 2019·The Journal of Thoracic and Cardiovascular Surgery·Philip A LindenChristopher W Towe
Apr 13, 2021·Journal of Surgical Oncology·Francine L JacobsonChristopher T Ducko
Nov 14, 2020·Seminars in Thoracic and Cardiovascular Surgery·Nakul ValsangkarOnkar V Khullar
Jul 8, 2021·Brazilian Journal of Anesthesiology·Clovis T Bevilacqua FilhoCristiano F Andrade
Feb 19, 2021·The Annals of Thoracic Surgery·Garrett N CoyanInderpal S Sarkaria
Sep 11, 2021·BMC Health Services Research·Andrew H HughesCharles F S Locke
Apr 22, 2021·The Annals of Thoracic Surgery·Zachary TranPeyman Benharash
Aug 15, 2021·The Annals of Thoracic Surgery·Travis C GeraciRobert J Cerfolio

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