Florencio Quero-Valenzuela1, Inmaculada Piedra-Fernández1, María Martínez-Ceres2, Pedro J Romero-Palacios3, Abel Sánchez-Palencia1, Antonio Cueto-Ladrón De Guevara1, Pablo Torné-Poyatos4. 1. Section of Thoracic Surgery, Hospital Universitario Virgen de las Nieves de Granada, Avda de las Armadas s/n 18001, Granada, Spain. 2. Respiratory Service, Hospital Universitario La Inmaculdada, C/ Alejandro Otero, 8, Granada, Spain. 3. Faculty of Medicine Unversidad de Granada, Respiratory Service, Hospital Universitario La Inmaculdada, C/ Alejandro Otero, 8, Granada, Spain. 4. Faculty of Medicine, Unversidad de Granada, Hospital Universitario Clinico, Campus de la Salud, Granada, Spain.
Abstract
BACKGROUND: The purpose of this study was to assess the rate, cause, and factors associated with readmissions following pulmonary resection for lung cancer and their relationship with 90-day mortality. METHODS: A prospective cohort study was conducted of 379 patients who underwent surgery for lung cancer at the university hospitals Granada, Spain between 2012 and 2016. RESULTS: The rate of readmissions within 30 postoperative days was 6.2%. The most common reason for readmission was subcutaneous emphysema (21.7%), pneumonia (13%), and pleural empyema (8.5%). A higher probability of requiring urgent readmission was associated with a higher Charlson index (OR 2.0,95% confidence interval 1.50-2.67, P = 0.001); peripheral arterial vasculopathy (OR 4.8, 95%CI 1.27-18.85, P = 0.021); a history of stroke (OR 8.2, 95%CI 1.08-62.37, P = 0.04); postoperative atelectasis (OR 4.7, 95%CI 1.21-18.64, P = 0.026); and air leaks (OR 12.6, 95%CI 4.10-38.91, P = 0.001).The prediction multivariable model for readmission represents an area under the curve (ROC) of 0.90. Mortality at 90 postoperative days in the group of readmitted patients was 13% versus 1.5 for the group of patients who did not require readmission (P < 0.001). CONCLUSIONS: The factors predictive for readmission can help design individualized outpatient follow-up plans and programs for the reduction of readmissions.
BACKGROUND: The purpose of this study was to assess the rate, cause, and factors associated with readmissions following pulmonary resection for lung cancer and their relationship with 90-day mortality. METHODS: A prospective cohort study was conducted of 379 patients who underwent surgery for lung cancer at the university hospitals Granada, Spain between 2012 and 2016. RESULTS: The rate of readmissions within 30 postoperative days was 6.2%. The most common reason for readmission was subcutaneous emphysema (21.7%), pneumonia (13%), and pleural empyema (8.5%). A higher probability of requiring urgent readmission was associated with a higher Charlson index (OR 2.0,95% confidence interval 1.50-2.67, P = 0.001); peripheral arterial vasculopathy (OR 4.8, 95%CI 1.27-18.85, P = 0.021); a history of stroke (OR 8.2, 95%CI 1.08-62.37, P = 0.04); postoperative atelectasis (OR 4.7, 95%CI 1.21-18.64, P = 0.026); and air leaks (OR 12.6, 95%CI 4.10-38.91, P = 0.001).The prediction multivariable model for readmission represents an area under the curve (ROC) of 0.90. Mortality at 90 postoperative days in the group of readmitted patients was 13% versus 1.5 for the group of patients who did not require readmission (P < 0.001). CONCLUSIONS: The factors predictive for readmission can help design individualized outpatient follow-up plans and programs for the reduction of readmissions.
Authors: Ankit Bharat; Martín Angulo; Haiying Sun; Mahzad Akbarpour; Andrés Alberro; Yuan Cheng; Masahiko Shigemura; Sergejs Berdnikovs; Lynn C Welch; Jacob A Kanter; G R Scott Budinger; Emilia Lecuona; Jacob I Sznajder Journal: Am J Respir Cell Mol Biol Date: 2020-08 Impact factor: 6.914