Effect of On-Site Cardiac Surgery Program on General Thoracic Surgery Outcomes.

Area of Science:

• Thoracic Surgery
• Surgical Outcomes
• Healthcare Management

Background:

• Limited data exist on the impact of multispecialty surgical collaboration in general thoracic surgery.
• The presence of an on-site cardiac surgery program may influence patient outcomes.

Purpose of the Study:

• To investigate if an on-site cardiac surgery program is associated with improved outcomes in general thoracic surgery.
• To analyze the relationship between cardiac surgery presence and outcomes for lobectomy, pneumonectomy, and esophagectomy.

Main Methods:

• Utilized the Nationwide Inpatient Sample (NIS) from 1999-2008.
• Included 389,959 patients undergoing lobectomy, pneumonectomy, or esophagectomy.
• Compared outcomes between hospitals with and without on-site cardiac surgery programs using univariate and multivariate analyses.

Main Results:

• Univariate analysis showed lower mortality for lobectomy and esophagectomy in hospitals with cardiac surgery programs (p < 0.001).
• All-cause morbidity was lower for all three procedures in hospitals with cardiac surgery programs.
• Multivariate analysis revealed that cardiac surgery programs were not independent predictors of outcomes when adjusted for confounders like procedure volume and hospital teaching status.

Conclusions:

• An on-site cardiac surgery program is not independently associated with better general thoracic surgery outcomes.
• Cardiac surgery programs may act as surrogates for other predictors of improved outcomes, such as hospital teaching status and procedure volume.