Author of

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  P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall

  • 27461

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    P3.01-102 - Potential Predictors of Unexpected Readmission After Lung Resection (ID 14403)

    12:00 - 13:30  |  Author(s): Yukihiro Yoshida
    • Abstract
    • Slides

    Background
    

    Postoperative unexpected readmissions are sentinel events that negatively impact patients. Previous analyses of risk factors of unexpected readmission after lung resection have identified several predictive factors. However, both the operative procedures and perioperative care can vary between institutions. The current study aimed to investigate the incidence levels and potential predictors of unexpected readmission after lung cancer surgery at our institution.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Patients who underwent lung resection for primary lung cancers between January 2016 and December 2017 at our institution were enrolled in this study. Operative procedures included pneumonectomy, lobectomy, segmentectomy, and wedge resection. Pleural biopsy and unresectable cases were excluded from this study. Unexpected readmissions were defined as an unscheduled readmission after surgery to our hospital. All patients were examined at our outpatient clinic within 14 days after initial discharge. Thirty-day readmission rates and diagnoses were edaluated. Univariate analysis was performed to identify perioperative factors associated readmission.

    4c3880bb027f159e801041b1021e88e8 Result
    

    During the 24-month study period, 1,000 patients underwent lung resection for primary cancer. The median age was 69 years (32–90 years). Fourteen pneumonectomies, 687 lobectomies, 193 segmentectomies, and 106 wedge resections were performed. The median length of postoperative hospital stay was 4 days (2–117 days). The 30-day mortality rate was 0.3% (3 of 1,000 patients). Forty-three patients (4.3%) experienced an unexpected readmission within 30 days after discharge. The median interval to readmission from the day of discharge was 10 days (1-29 days). The most common diagnoses for readmission were empyema (n=11; 26%), exacerbation of interstitial pneumonia (n=7; 16%), pneumothorax (n=7; 16%), and pneumonia (n=5; 12%). The median length of readmission hospital stay was 10 days (2–90 days). Among readmitted patients, 9.3% (4 of 43) had died in the hospital due to exacerbation of interstitial pneumonia. In a univariate analysis, significant factors (p<0.05) associated with increased risk of unexpected readmission were man, smoking history, diabetes mellitus, larger tumor size, positive lymph node, either lobectomy or pneumonectomy, longer operative time, either prolonged air leakage (i.e., more than 5 days) or reoperation for air leakage, longer hospital stay after initial surgery.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    The unexpected readmission rate after lung resection was 4.3% (n=43), with respiratory complications (n=30; 70%) being the most common cause. Four patients (9.3%) died in the hospital due to exacerbation of interstitial pneumonia. Several perioperative factors were identified as risk factors for readmission in this study.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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