Predictors for 30‐day readmission after pulmonary resection for lung cancer

摘要

Background: The purpose of this study was to assess the rate, cause, and factors associated with readmissions following pulmonary resection for lung cancer and their relationship with 90‐day mortality. Methods: A prospective cohort study was conducted of 379 patients who underwent surgery for lung cancer at the university hospitals Granada, Spain between 2012 and 2016. Results: The rate of readmissions within 30 postoperative days was 6.2%. The most common reason for readmission was subcutaneous emphysema (21.7%), pneumonia (13%), and pleural empyema (8.5%). A higher probability of requiring urgent readmission was associated with a higher Charlson index (OR 2.0,95% confidence interval 1.50‐2.67, P ?=?0.001); peripheral arterial vasculopathy (OR 4.8, 95%CI 1.27‐18.85, P ?=?0.021); a history of stroke (OR 8.2, 95%CI 1.08‐62.37, P ?=?0.04); postoperative atelectasis (OR 4.7, 95%CI 1.21‐18.64, P ?=?0.026); and air leaks (OR 12.6, 95%CI 4.10‐38.91, P ?=?0.001).The prediction multivariable model for readmission represents an area under the curve (ROC) of 0.90. Mortality at 90 postoperative days in the group of readmitted patients was 13% versus 1.5 for the group of patients who did not require readmission ( P ??0.001). Conclusions: The factors predictive for readmission can help design individualized outpatient follow‐up plans and programs for the reduction of readmissions.