التفاصيل البيبلوغرافية
| العنوان: |
The differential impact of preoperative comorbidity on perioperative outcomes following thoracoscopic and open lobectomies. |
| المؤلفون: |
Jawitz, Oliver K., Zuoheng Wang, Boffa, Daniel J., Detterbeck, Frank C., Blasberg, Justin D., Kim, Anthony W. |
| المصدر: |
European Journal of Cardio-Thoracic Surgery; Jan2017, Vol. 51 Issue 1, p169-174, 6p |
| مصطلحات موضوعية: |
CHEST endoscopic surgery, OPERATIVE surgery, LOBECTOMY (Lung surgery), PREOPERATIVE period, LUNG surgery, COMORBIDITY, EPIDEMIOLOGY |
| مستخلص: |
OBJECTIVES: Video-assisted thoracoscopic surgery (VATS) lobectomy is quickly becoming the standard of care for many patients with early-stage non-small-cell lung cancer (NSCLC) and benign lung conditions. There is a lack of published data defining the differential impact of preoperative patient comorbidity on outcomes following VATS and OPEN lobectomies, which would be beneficial for procedure selection and clinical decision-making. METHODS: A retrospective analysis of the 2008-2011 Nationwide Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP) database was performed. Demographic and clinical data on patients ≥18 years having undergone VATS or OPEN lobectomy were included. Measured outcomes included postoperative length of stay (PO-LOS), in-hospital mortality and perioperative pulmonary complications. PO-LOS was further analysed using multivariable logistic regression and cumulative incidence models. RESULTS: VATS lobectomies were associated with shorter PO-LOS and fewer complications even after censoring for inpatient mortality. Furthermore, VATS lobectomy patients had improved PO-LOS compared with OPEN lobectomy patients, even with greater comorbidity. Logistic regression modelling for PO-LOS ≥14 days identified independent predictors of prolonged PO-LOS, including male gender, nonelective admission, lower hospital lobectomy volume, several Elixhauser comorbidities and performance of OPEN lobectomy. CONCLUSIONS: The expected postoperative length of stay for a patient treated by OPEN lobectomy is approximately equal to that of a VATS lobectomy patient with an additional 2-3 comorbidities. The VATS approach remains advantageous with respect to PO-LOS, regardless of the number of comorbidities. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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