Predictors for 30‐day readmission after pulmonary resection for lung cancer

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 c...

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Published in:Journal of surgical oncology 2018-05, Vol.117 (6), p.1239-1245
Main Authors: Quero‐Valenzuela, Florencio, Piedra‐Fernández, Inmaculada, Martínez‐Ceres, María, Romero‐Palacios, Pedro J., Sánchez‐Palencia, Abel, De Guevara, Antonio Cueto‐Ladrón, Torné‐Poyatos, Pablo
Format: Article
Language:English
Subjects:
Aged
Cancer surgery
Female
Follow-Up Studies
Health risk assessment
Humans
Lung cancer
Lung Neoplasms - mortality
Lung Neoplasms - pathology
Lung Neoplasms - surgery
Male
mortality at 90 days
Patient Discharge
Patient Readmission - statistics & numerical data
Postoperative Complications - mortality
predictors
Prognosis
Prospective Studies
pulmonary resection
readmission
Risk Factors
Survival Rate
Time Factors
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Summary: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 
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.24973