Risk factors identified for prolonged stay after lobectomy.
"Following lobectomy for lung cancer, prolonged length of stay is a result of various operative and perioperative morbidities, and this is associated with higher overall morbidity and mortality compared to normal length of stay," said Dr. Cameron D. Wright of Massachusetts General Hospital, Boston.
"These predictors can be used by general thoracic surgeons who participate in the General Thoracic Database to provide risk-adjusted information to patients on their operative risk with lobectomy," he said in an interview.
The study presented at the annual meeting of the Society of Thoracic Surgeons, used the STS General Thoracic Database to identify all patients who underwent a lobectomy for lung cancer between January 2002 and June 2006.
Of the almost 5,000 lobectomies performed, 7% resulted in a prolonged length of stay (PLOS), defined as more than 14 days. The mean length of stay for patients with PLOS was 26 days, compared with 6 days for patients without PLOS.
"PLOS was associated with significantly more complications--3.4 events per day compared to 1.2 events," he noted.
For example, significantly more pulmonary complications, such as air leak for more than 5 days (36% vs. 8%), pneumonia (28% vs. 3%), acute respiratory distress syndrome (11% vs. 1%), and reintubation (33% vs. 1%), were noted in the patients with PLOS, Dr. Wright reported.
Mortality also increased in the PLOS group (10.8% vs. 0.71%), he said. Induction therapy, male gender, older age, the forced expiratory volume in 1 second percentage, an American Society of Anesthesiologists score of 3 or 4, and high Zubrod scores were all associated with significantly higher risk.
The study provides the first risk model for the General Thoracic Database, Dr. Wright said.
BY KATE JOHNSON Montreal Bureau
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|Title Annotation:||Pulmonary Medicine|
|Publication:||Internal Medicine News|
|Article Type:||Brief article|
|Date:||May 1, 2008|
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