Predicting Non-home Discharge After Lung Surgery: Analysis of the General Thoracic Surgery Database

Area of Science:

• Thoracic Surgery
• Oncology
• Health Services Research

Background:

• Anticipating non-home discharge (NHD) improves patient counseling and expedites placement.
• This can potentially reduce length of stay and hospital readmissions.
• A simple, preoperative clinical prediction tool for NHD is needed.

Purpose of the Study:

• To create a simple, preoperative clinical prediction tool for non-home discharge (NHD).
• To utilize The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD) for tool development.

Main Methods:

• Querying the STS GTSD for elective anatomic lung cancer resections (2009-2019).
• Excluding patients based on specific criteria (e.g., age, lung function, disease stage).
• Developing a nomogram using multivariable logistic regression and cross-validation.

Main Results:

• 35,948 patients met inclusion criteria.
• Key predictors for NHD included age, lung function, open surgery, cerebrovascular history, and Zubrod score.
• The nomogram achieved an area under the curve of 0.74, indicating good discriminatory ability.

Conclusions:

• A preoperative nomogram effectively predicts NHD risk after anatomic lung resection.
• The tool demonstrates good discriminatory ability using readily available variables.
• Risk stratification facilitates improved patient counseling and postoperative care planning.