Early discharge after lung resection is safe: 10-year experience

Area of Science:

• Thoracic Surgery
• Surgical Outcomes
• Patient Discharge

Background:

• Average hospitalization after lung resection is 6 days.
• Factors influencing early discharge (ED) and its safety are not well-understood.
• Hypothesis: Specific patient populations are associated with ED, with low complication rates.

Purpose of the Study:

• Identify patient factors associated with early discharge (ED) after lung resection.
• Evaluate the safety and complication rates of ED.
• Compare patients with ED to those with longer lengths of stay (LOS).

Main Methods:

• Prospective database of lung resections (Jan 2007-Jan 2017) at an academic medical center.
• ED defined as LOS in the lowest quintile for anatomic resection (AR) or wedge resection (WR).
• Compared clinical factors between ED patients and those discharged by day 7.

Main Results:

• 448 (39.0%) wedge resections with early discharge (WRED) and 211 (22.9%) anatomic resections with early discharge (ARED) identified.
• ED associated with younger age, better lung function, and lower ASA class.
• WRED had low 30-day mortality (0.22%); ARED showed no 30-day post-operative deaths in early discharged patients.

Conclusions:

• Early discharge after lung resection is safe in selected patients.
• Patient age, lung function, procedure duration, and surgeon influence ED.
• Standardized pathways can identify low-risk patients for expeditious discharge, potentially reducing LOS.