Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group Registry
Objective. There are limited data for estimating the risk of early discharge following thoracoscopic lobectomy. The objective was to identify the factors associated with a short length of stay and verify the influence of these variables in uncomplicated patients. Methods. We reviewed all lobectomies...
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/24/7356 |
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| author | Pio Maniscalco Nicola Tamburini Nicolò Fabbri Francesco Quarantotto Giovanna Rizzardi Dario Amore Camillo Lopez Roberto Crisci Lorenzo Spaggiari Giorgia Valpiani Luca Bertolaccini Giorgio Cavallesco on behalf of the VATS Group |
| author_facet | Pio Maniscalco Nicola Tamburini Nicolò Fabbri Francesco Quarantotto Giovanna Rizzardi Dario Amore Camillo Lopez Roberto Crisci Lorenzo Spaggiari Giorgia Valpiani Luca Bertolaccini Giorgio Cavallesco on behalf of the VATS Group |
| author_sort | Pio Maniscalco |
| collection | DOAJ |
| description | Objective. There are limited data for estimating the risk of early discharge following thoracoscopic lobectomy. The objective was to identify the factors associated with a short length of stay and verify the influence of these variables in uncomplicated patients. Methods. We reviewed all lobectomies reported to the Italian VATS Group between January 2014 and January 2020. Patients and perioperative characteristics were divided into two subgroups based on whether or not they met the target duration of stay (≤ or >4 days). The association between preoperative and intraoperative variables and postoperative length of stay (LOS) ≤4 days was assessed using a stepwise multivariable logistic regression analysis to identify factors independently associated with LOS and factors related to LOS in uncomplicated cases. Results. Among 10,240 cases who underwent thoracoscopic lobectomy, 37.6% had a hospital stay ≤4 days. Variables associated with LOS included age, hospital surgical volume, Diffusion Lung CO % (81 [69–94] vs. 85 [73–98]), Forced Expiratory Volume (FEV1) % (92 [79–106] vs. 96 [82–109]), operative time (180 [141–230] vs. 160 [125–195]), uniportal approach (571 [9%] vs. 713 [18.5%]), bioenergy sealer use, and pain control through intercostal block or opioids (<i>p</i> < 0.001). Except for FEV1 and blood loss, all other factors emerged significantly associated with LOS when the analysis was limited to uncomplicated patients. Conclusions. Demographic, clinical, and surgical variables are associated with early discharge after thoracoscopic lobectomy. This study indicates that these characteristics are associated with early discharge. This result can be used in association with clinical judgment to identify appropriate patients for fast-track protocols. |
| first_indexed | 2024-03-09T16:17:19Z |
| format | Article |
| id | doaj.art-f0c14d48796b46af9edc0d82ff59e6f2 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T16:17:19Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f0c14d48796b46af9edc0d82ff59e6f22023-11-24T15:44:10ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-011124735610.3390/jcm11247356Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group RegistryPio Maniscalco0Nicola Tamburini1Nicolò Fabbri2Francesco Quarantotto3Giovanna Rizzardi4Dario Amore5Camillo Lopez6Roberto Crisci7Lorenzo Spaggiari8Giorgia Valpiani9Luca Bertolaccini10Giorgio Cavallesco11on behalf of the VATS GroupDepartment of General Thoracic Surgery, Sant’Anna University Hospital, 44124 Ferrara, ItalyDepartment of General Thoracic Surgery, Sant’Anna University Hospital, 44124 Ferrara, ItalyDepartment of General Surgery, Sant’Anna University Hospital, 44124 Ferrara, ItalyDepartment of General Thoracic Surgery, Sant’Anna University Hospital, 44124 Ferrara, ItalyDepartment of Thoracic Surgery, Cliniche Humanitas Gavazzeni, 24125 Bergamo, ItalyDepartment of Thoracic Surgery, Monaldi Hospital, 80131 Naples, ItalyDepartment of Thoracic Surgery, Vito Fazzi Hospital, 73100 Lecce, ItalyDepartment of Thoracic Surgery, University of L’Aquila, 64100 L’Aquila, ItalyDepartment of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyResearch Innovation Quality and Accreditation Unit, Sant’Anna University Hospital, 44124 Ferrara, ItalyDepartment of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, ItalyDepartment of General Thoracic Surgery, Sant’Anna University Hospital, 44124 Ferrara, ItalyObjective. There are limited data for estimating the risk of early discharge following thoracoscopic lobectomy. The objective was to identify the factors associated with a short length of stay and verify the influence of these variables in uncomplicated patients. Methods. We reviewed all lobectomies reported to the Italian VATS Group between January 2014 and January 2020. Patients and perioperative characteristics were divided into two subgroups based on whether or not they met the target duration of stay (≤ or >4 days). The association between preoperative and intraoperative variables and postoperative length of stay (LOS) ≤4 days was assessed using a stepwise multivariable logistic regression analysis to identify factors independently associated with LOS and factors related to LOS in uncomplicated cases. Results. Among 10,240 cases who underwent thoracoscopic lobectomy, 37.6% had a hospital stay ≤4 days. Variables associated with LOS included age, hospital surgical volume, Diffusion Lung CO % (81 [69–94] vs. 85 [73–98]), Forced Expiratory Volume (FEV1) % (92 [79–106] vs. 96 [82–109]), operative time (180 [141–230] vs. 160 [125–195]), uniportal approach (571 [9%] vs. 713 [18.5%]), bioenergy sealer use, and pain control through intercostal block or opioids (<i>p</i> < 0.001). Except for FEV1 and blood loss, all other factors emerged significantly associated with LOS when the analysis was limited to uncomplicated patients. Conclusions. Demographic, clinical, and surgical variables are associated with early discharge after thoracoscopic lobectomy. This study indicates that these characteristics are associated with early discharge. This result can be used in association with clinical judgment to identify appropriate patients for fast-track protocols.https://www.mdpi.com/2077-0383/11/24/7356thoracoscopic lobectomyhospitalizationlength of hospital staylung cancerrisk factors |
| spellingShingle | Pio Maniscalco Nicola Tamburini Nicolò Fabbri Francesco Quarantotto Giovanna Rizzardi Dario Amore Camillo Lopez Roberto Crisci Lorenzo Spaggiari Giorgia Valpiani Luca Bertolaccini Giorgio Cavallesco on behalf of the VATS Group Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group Registry Journal of Clinical Medicine thoracoscopic lobectomy hospitalization length of hospital stay lung cancer risk factors |
| title | Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group Registry |
| title_full | Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group Registry |
| title_fullStr | Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group Registry |
| title_full_unstemmed | Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group Registry |
| title_short | Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group Registry |
| title_sort | factors associated with early discharge after thoracoscopic lobectomy results from the italian vats group registry |
| topic | thoracoscopic lobectomy hospitalization length of hospital stay lung cancer risk factors |
| url | https://www.mdpi.com/2077-0383/11/24/7356 |
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