Rachel L Medbery1, Theresa W Gillespie2, Yuan Liu3, Dana C Nickleach4, Joseph Lipscomb5, Manu S Sancheti1, Allan Pickens1, Seth D Force1, Felix G Fernandez6. 1. Section of General Thoracic Surgery, School of Medicine, Emory University, Atlanta, Georgia. 2. Division of Surgical Oncology, School of Medicine, Emory University, Atlanta, Georgia. 3. Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia; Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, Emory University, Atlanta, Georgia. 4. Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, Emory University, Atlanta, Georgia. 5. Division of Surgical Oncology, School of Medicine, Emory University, Atlanta, Georgia; Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia. 6. Section of General Thoracic Surgery, School of Medicine, Emory University, Atlanta, Georgia. Electronic address: felix.fernandez@emoryhealthcare.org.
Abstract
BACKGROUND: Data regarding risk factors for readmissions after surgical resection for lung cancer are limited and largely focus on postoperative outcomes, including complications and hospital length of stay. The current study aims to identify preoperative risk factors for postoperative readmission in early stage lung cancer patients. METHODS: The National Cancer Data Base was queried for all early stage lung cancer patients with clinical stage T2N0M0 or less who underwent lobectomy in 2010 and 2011. Patients with unplanned readmission within 30 days of hospital discharge were identified. Univariate analysis was utilized to identify preoperative differences between readmitted and not readmitted cohorts; multivariable logistic regression was used to identify risk factors resulting in readmission. RESULTS: In all, 840 of 19,711 patients (4.3%) were readmitted postoperatively. Male patients were more likely to be readmitted than female patients (4.9% versus 3.8%, p < 0.001), as were patients who received surgery at a nonacademic rather than an academic facility (4.6% versus 3.6%; p = 0.001) and had underlying medical comorbidities (Charlson/Deyo score 1+ versus 0; 4.8% versus 3.7%; p < 0.001). Readmitted patients had a longer median hospital length of stay (6 days versus 5; p < 0.001) and were more likely to have undergone a minimally invasive approach (5.1% video-assisted thoracic surgery versus 3.9% open; p < 0.001). In addition to those variables, multivariable logistic regression analysis identified that median household income level, insurance status (government versus private), and geographic residence (metropolitan versus urban versus rural) had significant influence on readmission. CONCLUSIONS: The socioeconomic factors identified significantly influence hospital readmission and should be considered during preoperative and postoperative discharge planning for patients with early stage lung cancer.
BACKGROUND: Data regarding risk factors for readmissions after surgical resection for lung cancer are limited and largely focus on postoperative outcomes, including complications and hospital length of stay. The current study aims to identify preoperative risk factors for postoperative readmission in early stage lung cancerpatients. METHODS: The National Cancer Data Base was queried for all early stage lung cancerpatients with clinical stage T2N0M0 or less who underwent lobectomy in 2010 and 2011. Patients with unplanned readmission within 30 days of hospital discharge were identified. Univariate analysis was utilized to identify preoperative differences between readmitted and not readmitted cohorts; multivariable logistic regression was used to identify risk factors resulting in readmission. RESULTS: In all, 840 of 19,711 patients (4.3%) were readmitted postoperatively. Male patients were more likely to be readmitted than female patients (4.9% versus 3.8%, p < 0.001), as were patients who received surgery at a nonacademic rather than an academic facility (4.6% versus 3.6%; p = 0.001) and had underlying medical comorbidities (Charlson/Deyo score 1+ versus 0; 4.8% versus 3.7%; p < 0.001). Readmitted patients had a longer median hospital length of stay (6 days versus 5; p < 0.001) and were more likely to have undergone a minimally invasive approach (5.1% video-assisted thoracic surgery versus 3.9% open; p < 0.001). In addition to those variables, multivariable logistic regression analysis identified that median household income level, insurance status (government versus private), and geographic residence (metropolitan versus urban versus rural) had significant influence on readmission. CONCLUSIONS: The socioeconomic factors identified significantly influence hospital readmission and should be considered during preoperative and postoperative discharge planning for patients with early stage lung cancer.
Authors: J R Handy; A I Child; G L Grunkemeier; P Fowler; J W Asaph; E C Douville; A C Tsen; G Y Ott Journal: Ann Thorac Surg Date: 2001-12 Impact factor: 4.330
Authors: Richard K Freeman; J Russell Dilts; Anthony J Ascioti; Megan Dake; Raja S Mahidhara Journal: Ann Thorac Surg Date: 2013-08-27 Impact factor: 4.330
Authors: Amin Madani; Julio F Fiore; Yifan Wang; Jimmy Bejjani; Lojan Sivakumaran; Juan Mata; Debbie Watson; Franco Carli; David S Mulder; Christian Sirois; Lorenzo E Ferri; Liane S Feldman Journal: Surgery Date: 2015-07-17 Impact factor: 3.982
Authors: Joshua E Rosen; Jacquelyn G Hancock; Anthony W Kim; Frank C Detterbeck; Daniel J Boffa Journal: Ann Thorac Surg Date: 2014-10-18 Impact factor: 4.330
Authors: Ravi Rajaram; Mila H Ju; Karl Y Bilimoria; Clifford Y Ko; Malcolm M DeCamp Journal: J Thorac Cardiovasc Surg Date: 2015-05-21 Impact factor: 5.209
Authors: Roland Assi; Daniel J Wong; Daniel J Boffa; Frank C Detterbeck; Zuoheng Wang; Geoffrey L Chupp; Anthony W Kim Journal: Ann Thorac Surg Date: 2014-12-12 Impact factor: 4.330
Authors: Onkar V Khullar; Theresa Gillespie; Dana C Nickleach; Yuan Liu; Kristin Higgins; Suresh Ramalingam; Joseph Lipscomb; Felix G Fernandez Journal: J Am Coll Surg Date: 2014-10-27 Impact factor: 6.113
Authors: Jessica R Glover; Frank O Velez-Cubian; Wei Wei Zhang; Kavian Toosi; Tawee Tanvetyanon; Emily P Ng; Carla C Moodie; Joseph R Garrett; Jacques P Fontaine; Eric M Toloza Journal: J Thorac Dis Date: 2016-12 Impact factor: 2.895
Authors: Florencio Quero Valenzuela; Inmaculada Piedra Fernández; Maria Del Carmen Martínez Cirre; Abel Sánchez-Palencia; Antonio Cueto Ladrón de Guevara Journal: J Thorac Dis Date: 2017-11 Impact factor: 2.895
Authors: Shruti Kulkarni; Liwei Chen; Anastasia Jermihov; Frank O Velez; Carla C Moodie; Joseph R Garrett; Jacques P Fontaine; Eric M Toloza Journal: Cureus Date: 2022-08-31