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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781100/ https://www.ncbi.nlm.nih.gov/pubmed/36555972 http://dx.doi.org/10.3390/jcm11247356 |
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author | Maniscalco, Pio Tamburini, Nicola Fabbri, Nicolò Quarantotto, Francesco Rizzardi, Giovanna Amore, Dario Lopez, Camillo Crisci, Roberto Spaggiari, Lorenzo Valpiani, Giorgia Bertolaccini, Luca Cavallesco, Giorgio |
author_facet | Maniscalco, Pio Tamburini, Nicola Fabbri, Nicolò Quarantotto, Francesco Rizzardi, Giovanna Amore, Dario Lopez, Camillo Crisci, Roberto Spaggiari, Lorenzo Valpiani, Giorgia Bertolaccini, Luca Cavallesco, Giorgio |
author_sort | Maniscalco, Pio |
collection | PubMed |
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 (p < 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. |
format | Online Article Text |
id | pubmed-9781100 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97811002022-12-24 Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group Registry Maniscalco, Pio Tamburini, Nicola Fabbri, Nicolò Quarantotto, Francesco Rizzardi, Giovanna Amore, Dario Lopez, Camillo Crisci, Roberto Spaggiari, Lorenzo Valpiani, Giorgia Bertolaccini, Luca Cavallesco, Giorgio J Clin Med Article 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 (p < 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. MDPI 2022-12-11 /pmc/articles/PMC9781100/ /pubmed/36555972 http://dx.doi.org/10.3390/jcm11247356 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Maniscalco, Pio Tamburini, Nicola Fabbri, Nicolò Quarantotto, Francesco Rizzardi, Giovanna Amore, Dario Lopez, Camillo Crisci, Roberto Spaggiari, Lorenzo Valpiani, Giorgia Bertolaccini, Luca Cavallesco, Giorgio Factors Associated with Early Discharge after Thoracoscopic Lobectomy: Results from the Italian VATS Group Registry |
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 | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781100/ https://www.ncbi.nlm.nih.gov/pubmed/36555972 http://dx.doi.org/10.3390/jcm11247356 |
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