Risk Factors for Readmission After Pulmonary Lobectomy: A Quality Collaborative Study

Area of Science:

• Thoracic Surgery
• Oncology
• Health Services Research

Background:

• Previous studies linked postoperative complications to readmission after lobectomy.
• These studies often failed to account for complication timing or institutional factors.
• This study aimed to analyze readmission rates and associated factors after lobectomy, considering these limitations.

Purpose of the Study:

• To examine readmission rates following lobectomy for lung cancer.
• To identify key factors associated with readmission after lobectomy.
• To investigate the impact of complication timing and institutional effects on readmission.

Main Methods:

• Utilized a statewide database of patients over 18 undergoing lobectomy for lung cancer (2015-2019).
• Excluded patients with in-hospital mortality, missing discharge/readmission data, or specific discharge locations.
• Employed logistic mixed-model analysis with hospitals as random intercepts to account for institutional effects and complication timing.

Main Results:

• Overall readmission rate was 6.9% (184/2686).
• Air leak ≥5 days was the most frequent complication (17.4%).
• Predischarge complications and higher Zubrod scores predicted increased readmission; longer length of stay, higher institutional volume, and early follow-up (≤7 days) predicted decreased readmission.

Conclusions:

• Postoperative complications significantly increase the risk of readmission after lobectomy.
• Follow-up within 7 days post-discharge is associated with reduced readmission risk.
• Strategies to reduce readmissions should target complication reduction, optimized discharge timing for complicated cases, and timely follow-up.