Skip to main content
Journal cover image

Factors Associated With Successful Postoperative Day One Discharge After Anatomic Lung Resection.

Publication ,  Journal Article
Towe, CW; Thibault, DP; Worrell, SG; Bachman, KC; Perry, Y; Kosinski, AS; Linden, PA
Published in: Ann Thorac Surg
July 2021

BACKGROUND: There are no criteria to estimate the risk of early discharge after anatomic lung resection. We hypothesized that demographic, clinical, and surgical variables could be used to predict successful postoperative day 1 (POD1) discharge after anatomic lung resection. METHODS: Patients with POD1 discharge after anatomic lung resection were identified in The Society of Thoracic Surgeons database from 2012 to 2018. Discharges were categorized as successful based on freedom from complications, readmission, or death. A multivariable model identified variables from univariate analysis and was further optimized using stepwise selection. This model was used to create a risk score of success. RESULTS: Among 62,785 patients who underwent anatomic lung resection, 2480 (3.9%) were discharged on POD1. Of the 2480 patients, 2129 (85.8%) had successful discharge and 351 (14.2%) had failed discharge due to postoperative complication (282; 11.3%), readmission (151; 6.1%), or death (9; 0.4%). In univariable analysis, successful POD1 discharge was associated with younger age, female sex, video-assisted thoracic surgery, higher forced expiratory volume in 1 second and diffusion capacity of lung for carbon monoxide, shorter operating room times, and lower rates of comorbidities. A risk model for successful discharge incorporated sex, age, body mass index, operative lobe, Zubrod score, American Society of Anesthesiologists class, coronary artery disease, chronic obstructive pulmonary disease, video-assisted thoracic surgery approach, and operating room time. Using this model, a risk score created, and derived estimated proportion of successful POD1 discharge varied from 75.6% to 92.9%. CONCLUSIONS: Demographic, clinical, and surgical variables are associated with successful POD1 discharge. This analysis suggests that a combination of demographic factors is associated with failed early discharge, and this understanding can be used in conjunction with clinical judgment to facilitate decisions regarding appropriateness of POD1 discharge.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

July 2021

Volume

112

Issue

1

Start / End Page

221 / 227

Location

Netherlands

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Respiratory System
  • Pulmonary Surgical Procedures
  • Postoperative Complications
  • Pneumonectomy
  • Patient Readmission
  • Patient Discharge
  • Multivariate Analysis
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Towe, C. W., Thibault, D. P., Worrell, S. G., Bachman, K. C., Perry, Y., Kosinski, A. S., & Linden, P. A. (2021). Factors Associated With Successful Postoperative Day One Discharge After Anatomic Lung Resection. Ann Thorac Surg, 112(1), 221–227. https://doi.org/10.1016/j.athoracsur.2020.07.059
Towe, Christopher W., Dylan P. Thibault, Stephanie G. Worrell, Katelynn C. Bachman, Yaron Perry, Andrzej S. Kosinski, and Philip A. Linden. “Factors Associated With Successful Postoperative Day One Discharge After Anatomic Lung Resection.Ann Thorac Surg 112, no. 1 (July 2021): 221–27. https://doi.org/10.1016/j.athoracsur.2020.07.059.
Towe CW, Thibault DP, Worrell SG, Bachman KC, Perry Y, Kosinski AS, et al. Factors Associated With Successful Postoperative Day One Discharge After Anatomic Lung Resection. Ann Thorac Surg. 2021 Jul;112(1):221–7.
Towe, Christopher W., et al. “Factors Associated With Successful Postoperative Day One Discharge After Anatomic Lung Resection.Ann Thorac Surg, vol. 112, no. 1, July 2021, pp. 221–27. Pubmed, doi:10.1016/j.athoracsur.2020.07.059.
Towe CW, Thibault DP, Worrell SG, Bachman KC, Perry Y, Kosinski AS, Linden PA. Factors Associated With Successful Postoperative Day One Discharge After Anatomic Lung Resection. Ann Thorac Surg. 2021 Jul;112(1):221–227.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

July 2021

Volume

112

Issue

1

Start / End Page

221 / 227

Location

Netherlands

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Respiratory System
  • Pulmonary Surgical Procedures
  • Postoperative Complications
  • Pneumonectomy
  • Patient Readmission
  • Patient Discharge
  • Multivariate Analysis
  • Middle Aged