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Assessment of short readmissions following elective pulmonary lobectomy

      Highlights

      • Few studies have assessed factors associated with the length of readmission following elective pulmonary lobectomy.
      • In this study including 19947 receiving lobectomies, readmissions were common, occurring in 10.9% of cases.
      • Shorter readmission length of stay was associated with patient insurance status and being readmitted to a non-index facility.
      • Primary diagnosis codes at readmission also differed significantly with length of readmission.
      • Interventions that reduce readmissions are critical to mitigate costs and improve patient outcomes following lobectomy.

      Abstract

      Background

      Reducing readmissions is critical for improving patient care and lowering costs. Despite this, few studies have assessed length of readmission following pulmonary lobectomy.

      Methods

      Using the Healthcare Cost and Utilization Project New York State Inpatient Database, we identified adult patients undergoing elective pulmonary lobectomy (2007–2015) and assessed readmission within 30 days of hospital discharge. We analyzed the relationship between length of readmission and post-operative morbidity and mortality as well as primary diagnoses at readmission.

      Results

      Of 19947 included patients, 2173 (10.9%) were readmitted within 30 days. The median (IQR) length of readmission was 5 (2–8) days. Longer length of readmission was associated with significantly higher likelihood of major complication (for every 1-day increase, aOR = 1.14, 95% CI = 1.12–1.17, p < 0.001) and mortality (aOR = 1.03, 95% CI = 1.02–1.04, p < 0.001) within 90 days. Primary diagnosis codes at readmission differed significantly with length of readmission.

      Conclusions

      Interventions that target short readmissions may help to prevent a proportion of readmissions following elective lung resection.

      Keywords

      Abbreviations:

      AHRQ (Agency for Healthcare Research and Quality), HCUP (Healthcare Cost and Utilization Project), SID (State Inpatient Database), CMS (Centers for Medicare and Medicaid Services), ICD (International Classification of Diseases)
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