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Author Notes:

Corresponding Author: Felix G. Fernandez M.D., The Emory Clinic, Suite A2214, 1365 Clifton Road, NE, Atlanta, Georgia 30322, Office: 404 778-1108, Fax: 404 778-4346, felix.fernandez@emoryhealthcare.org

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Data used in the study are derived from a de-identified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology used, or the conclusions drawn from these data by the investigator.

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Research Funding:

Set acknowledgement: Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Respiratory System
  • Surgery
  • Cardiovascular System & Cardiology
  • LENGTH-OF-STAY
  • REDUCE HOSPITAL READMISSIONS
  • PULMONARY LOBECTOMY
  • DATA-BASE
  • MEDICARE BENEFICIARIES
  • VASCULAR-SURGERY
  • RISK-FACTORS
  • CARE
  • MORTALITY
  • IMPACT
  • Lung cancer surgery
  • Lobectomy
  • Readmission

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

Tools:

Journal Title:

Annals of Thoracic Surgery

Volume:

Volume 102, Number 5

Publisher:

, Pages 1660-1667

Type of Work:

Article | Post-print: After Peer Review

Abstract:

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.

Copyright information:

© 2016 by The Society of Thoracic Surgeons Published by Elsevier

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