Factors Associated With Inappropriate Hospital Stay After Uncomplicated Resection of c-Stage I Non-Small-Cell Lung...

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Healthcare Management

Background:

• Inappropriate hospital stays increase costs and bed shortages.
• Overemphasis on minor symptoms or surgeon caution can prolong stays.
• This study examines predictors of extended hospital stays in early-stage non-small cell lung cancer (NSCLC) patients.

Purpose of the Study:

• To identify predictors of inappropriate hospital stay in patients undergoing uncomplicated resection for c-stage I NSCLC.
• To analyze factors influencing both theoretically inappropriate stay (TIS) and actual inappropriate stay (AIS).

Main Methods:

• Reviewed 216 patients undergoing NSCLC resection.
• Calculated surgical risk and predicted stay using the ACS-NSQIP system.
• Defined TIS and AIS based on predicted vs. actual stay and discharge criteria.
• Utilized linear and quantile regression to analyze predictors like surgical approach and resection extent.

Main Results:

• Mean hospital stay was 5.0 days; 72.2% had TIS ≥ 1 day, and 74.5% had AIS ≥ 1 day.
• Surgical risk profile, approach, and extent of resection were associated with hospital stay length.
• Extent of resection was the strongest independent predictor of AIS, with less extensive resections associated with shorter stays.

Conclusions:

• A significant proportion of patients with early-stage NSCLC experience inappropriate hospital stays.
• Findings can inform strategies for more efficient discharge planning in thoracic surgery.
• Sublobar resection may optimize hospital stay when oncologically suitable.