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Risk-adjusted discrete increases in length of stay by complication following anatomic lung resection: an analysis of 32 133 cases across the USA.
Stuart, Christina M; Bronsert, Michael R; Dyas, Adam R; Mott, Nicole M; Healy, Garrett L; Anioke, Tochi; Henderson, William G; Randhawa, Simran K; David, Elizabeth A; Mitchell, John D; Meguid, Robert A.
Afiliación
  • Stuart CM; Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Bronsert MR; Surgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Dyas AR; Surgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Mott NM; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Healy GL; Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Anioke T; Surgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Henderson WG; Division of Cardiothoracic Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Randhawa SK; Surgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • David EA; Surgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Mitchell JD; Surgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  • Meguid RA; Surgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Eur J Cardiothorac Surg ; 66(2)2024 Aug 02.
Article en En | MEDLINE | ID: mdl-39107905
ABSTRACT

OBJECTIVES:

Prior studies have associated morbidity following anatomic lung resection with prolonged postoperative length of stay; however, each complication's individual impact on length of stay as a continuous variable has not been studied. The purpose of this study was to determine the risk-adjusted increase in length of stay associated with each individual postoperative complications following anatomic lung resection.

METHODS:

Patients who underwent anatomic lung resection cataloged in the prospectively collected American College of Surgeons National Surgical Quality Improvement Program participant use file, 2005-2018, were targeted. The association between preoperative characteristics, postoperative complications and length of stay in days was tested. A negative binomial model adjusting for the effect of preoperative characteristics and 18 concurrent postoperative complications was used to generate incidence rate ratios. This model was fit to generate risk-adjusted increases in length of stay by complication.

RESULTS:

Of 32 133 patients, 5065 patients (15.8%) experienced at least one post-operative complication. The most frequent complications were pneumonia (n = 1829, 5.7%), the need for transfusion (n = 1794, 5.6%) and unplanned reintubation (n = 1064, 3.3%). The occurrence of each of the 18 individual complications was associated with significantly increased length of stay. This finding persisted after risk-adjustment, with the greatest risk-adjusted increases being associated with prolonged ventilation (+17.4 days), followed by septic shock (+17.2 days), acute renal failure (+16.5 days) and deep surgical site infection (+13.2 days).

CONCLUSIONS:

All 18 postoperative complications studied following anatomic lung resection were associated with significant risk-adjusted increases in length of stay, ranging from an increase of 17.4 days with prolonged ventilation to 2.6 days following the need for transfusion.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonectomía / Complicaciones Posoperatorias / Tiempo de Internación Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonectomía / Complicaciones Posoperatorias / Tiempo de Internación Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania