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Updated: May 24, 2026

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Does fast-tracking increase the readmission rate after pulmonary resection? A case-matched study.

Michele Salati1, Alessandro Brunelli, Francesco Xiumè

  • 1Unit of Thoracic Surgery, United Hospitals Ancona, Ancona, Italy. michelesalati@hotmail.com

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|February 25, 2012
PubMed
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Fast-tracking after pulmonary lobectomy significantly reduces hospital stay by 2.8 days without increasing patient readmission rates. This enhanced patient management strategy improves recovery efficiency following major lung resection surgery.

Area of Science:

  • Thoracic Surgery
  • Patient Management
  • Clinical Protocols

Background:

  • Fast-tracking is an evolving patient management strategy in thoracic surgery.
  • Clinical protocols and standardized care pathways aim to shorten postoperative stays after major lung resections.
  • This study evaluated the safety of a fast-tracking program by monitoring patient readmission rates.

Purpose of the Study:

  • To assess the safety and impact of a fast-tracking program implemented in 2008.
  • To compare readmission rates between patients managed with and without fast-tracking after pulmonary lobectomy.
  • To verify if reduced postoperative stay affects patient safety.

Main Methods:

  • Prospective observational study of 914 pulmonary lobectomies (2000-2010).

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  • Patients divided into early (2000-2007, non-fast-tracked) and recent (2008-2010, fast-tracked) periods.
  • Propensity score matching used to compare 232 pairs on outcomes and 30-day readmission rates.
  • Main Results:

    • Fast-tracking reduced postoperative stay by 2.8 days (P < 0.0001).
    • A 3-fold increase in patients discharged before postoperative day 6 was observed (P < 0.0001).
    • No significant difference in readmission rates was found between fast-tracked and non-fast-tracked groups.

    Conclusions:

    • Implementation of a fast-tracking program is effective and safe for pulmonary lobectomy patients.
    • Fast-tracking successfully reduces hospital stay duration.
    • The safety of the fast-tracking policy is confirmed by stable readmission rates.