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Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
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Is intensive care necessary after major thoracic surgery? A propensity score-matched study
Talha Dogruyol1, Selime Kahraman1, Sinem Dogruyol2
1Department of Thoracic Surgery, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Dergisi
|July 24, 2023
Summary
Postoperative care in the general ward for major thoracic surgery patients is safe and cost-effective. This approach reduces inpatient costs without increasing complications, benefiting patient outcomes.
Area of Science:
- Thoracic Surgery
- Critical Care Medicine
- Health Economics
Background:
- Major thoracic surgery necessitates careful postoperative management.
- Patient outcomes and costs vary based on postoperative care location (ICU vs. general ward).
- Identifying factors influencing postoperative complications is crucial.
Purpose of the Study:
- To compare surgical outcomes, complications, mortality, and inpatient costs between intensive care unit (ICU) and general ward post-major thoracic surgery.
- To identify clinical and surgical factors associated with postoperative complications.
Main Methods:
- Retrospective analysis of 485 patients undergoing major thoracic surgery.
- Patients divided into ICU (n=254) and general ward (n=231) groups.
- Propensity score matching used for group comparison; analysis of morbidity risk factors.
Main Results:
- Post-propensity score matching, 123 patients were in each group.
- No significant difference in most outcomes, but higher inpatient costs in the ICU group.
- Age, ASA Class 3, and secondary malignancy were linked to increased morbidity.
Conclusions:
- Postoperative general ward care for most major thoracic surgery patients is safe and cost-effective in experienced centers.
- Optimizing postoperative care location can reduce healthcare costs.
- Further research into specific patient selection criteria for general ward care is warranted.
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