Emergency hospital readmission after major lung resection: prevalence and related variables.

Abstract

To evaluate the rate, causes and variables related to emergency hospital readmission after scheduled major lung resection. An university general hospital in a managed care health system. Databases of 727 patients undergoing scheduled major lung resection between 1994 and 2003 have been reviewed, excluding hospital mortality from the analysis. The studied outcome was the occurrence of emergency hospital readmission by any surgery-related cause, at any centre, during the first 30 days after discharge. Independent studied variables were: age of the patient, body mass index, predicted postoperative FEV1% (ppoFEV1%), type of surgery (lobectomy or pneumonectomy), postoperative morbidity and length of stay (LOS). Descriptive statistics have been performed and forward step-wise logistic regression has been used to select predictive variables. Rate of emergency readmission was 6.9% (50 cases); 3 patients (6%) died. Pleural empyema without bronchial fistula (18 cases) was the most frequent cause of readmission. On logistic-regression analysis, pneumonectomy (odds ratio 3.84; 95%CI: 1.98-7.45) and major postoperative morbidity (odds ratio 2.42; 95%CI: 1.26-4.66) showed independent correlation to the outcome. Readmission rate after lung resection is around 7% and it is not influenced by LOS; patients experiencing major postoperative morbidity and pneumonectomy cases have the highest probability to be readmitted within 30 days after lung resection.