Details

Autor(en) / Beteiligte

• Medbery, Rachel L., MD
• Gillespie, Theresa W., PhD, MA
• Liu, Yuan, PhD
• Nickleach, Dana C., MA
• Lipscomb, Joseph, PhD
• Sancheti, Manu S., MD
• Pickens, Allan, MD
• Force, Seth D., MD
• Fernandez, Felix G., MD, MS

Titel

Socioeconomic Factors Are Associated With Readmission After Lobectomy for Early Stage Lung Cancer

Ist Teil von

• The Annals of thoracic surgery, 2016-11, Vol.102 (5), p.1660-1667

Ort / Verlag

Netherlands: Elsevier Inc

Erscheinungsjahr

2016

Quelle

EZB-FREE-00999 freely available EZB journals

Beschreibungen/Notizen

• Background Data regarding risk factors for readmissions after surgical resection for lung cancer are limited and largely focus on postoperative outcomes, including complications and hospital length of stay. The current study aims to identify preoperative risk factors for postoperative readmission in early stage lung cancer patients. Methods The National Cancer Data Base was queried for all early stage lung cancer patients with clinical stage T2N0M0 or less who underwent lobectomy in 2010 and 2011. Patients with unplanned readmission within 30 days of hospital discharge were identified. Univariate analysis was utilized to identify preoperative differences between readmitted and not readmitted cohorts; multivariable logistic regression was used to identify risk factors resulting in readmission. Results In all, 840 of 19,711 patients (4.3%) were readmitted postoperatively. Male patients were more likely to be readmitted than female patients (4.9% versus 3.8%, p < 0.001), as were patients who received surgery at a nonacademic rather than an academic facility (4.6% versus 3.6%; p  = 0.001) and had underlying medical comorbidities (Charlson/Deyo score 1+ versus 0; 4.8% versus 3.7%; p < 0.001). Readmitted patients had a longer median hospital length of stay (6 days versus 5; p < 0.001) and were more likely to have undergone a minimally invasive approach (5.1% video-assisted thoracic surgery versus 3.9% open; p < 0.001). In addition to those variables, multivariable logistic regression analysis identified that median household income level, insurance status (government versus private), and geographic residence (metropolitan versus urban versus rural) had significant influence on readmission. Conclusions The socioeconomic factors identified significantly influence hospital readmission and should be considered during preoperative and postoperative discharge planning for patients with early stage lung cancer.