- A retrospective analysis has identified prolonged air leakage after lung resection as a predictor of subsequent hospital readmission.
Why this matters
- Hospital readmission after lung cancer surgery can prelude a bad outcome.
- Risk factors of unexpected readmission have been examined, but studies were small and findings vary between institutions.
- More definitive data are necessary.
- Single institution study.
- Retrospective examination of records of patients who underwent lung resection for primary lung cancers from January 2016 through December 2017.
- Pleural biopsy and unresectable cases excluded.
- Tumors classified according to the 8th edition of WHO criteria.
- Unexpected remission defined as unscheduled remission within 30 days after discharge.
- 1000 patients; median age, 69 years (range, 32-90 years).
- 54% men, 46% women.
- Smoking history: 9% current, 36% never, 55% former.
- Lung involvement: 61% right, 39% left.
- Surgery mainly lobectomy (69%), followed by segmentectomy (19%) and wedge resection (11%).
- Median (range) postoperative stay: 4 (2-117) days.
- Unexpected readmission for 43 (4.3%) patients.
- Of those readmitted, 4 (9.3%) died because of exacerbation of interstitial pneumonitis.
- Univariate analysis comparison of readmitted vs nonreadmitted patients revealed age (P=.002), pack-year smoking (P=.001), diabetes mellitus (P=.022), maximum tumor size (P=.006), clinical nodal status of N0 (P=.039), blood transfusion (P=.017), pneumonia (P<.001 and prolonged postoperative air leakage as predictors of unexpected readmission.>
- In multivariate analysis, prolonged postoperative air leakage remained a predictor (HR, 3.52; 95% CI, 1.608-7.287; P=.004).
- "Surgical morbidity and mortality were low and acceptable. Intraoperatively, controlling air leakage will be the most important factor to prevent readmission. Intensive follow-up should be done for patients who have prolonged air leakage," said presenter Shinsuke Uchida, MD, PhD, National Cancer Center Hospital, Tokyo, Japan.