Identifying Drivers of Multiple Readmissions After Pulmonary Lobectomy

Area of Science:

• Thoracic Surgery
• Surgical Quality Improvement
• Oncology

Background:

• Pulmonary lobectomy for lung cancer is a critical procedure.
• Readmissions post-lobectomy impact healthcare quality and resources.
• Multiple readmissions present magnified challenges.

Purpose of the Study:

• To investigate factors associated with single and multiple readmissions after pulmonary lobectomy for lung cancer.
• To compare diagnoses for first and second readmissions within 90 days post-surgery.

Main Methods:

• Analysis of the Nationwide Readmission Database (2013-2014).
• Inclusion of patients with primary lung cancer diagnosis undergoing pulmonary lobectomy.
• Utilized adjusted hierarchical regression models to identify risk factors for readmissions.
• Compared primary diagnoses for first and second readmissions using Clinical Classification Software codes.

Main Results:

• 16.9% of patients (7,030/41,576) were readmitted post-lobectomy.
• 3.7% of patients (1,554/41,576) experienced at least two readmissions.
• Postoperative arrhythmia, infection, and sepsis during index hospitalization increased risk of multiple readmissions.
• First readmissions: postoperative complications (12.7%). Second readmissions: heart disease (11.2%).

Conclusions:

• Nearly one-fifth of readmitted patients faced multiple 90-day readmissions.
• First readmissions often stemmed from postoperative complications.
• Second readmissions were frequently linked to heart disease, indicating evolving patient needs.