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Multicentre review of readmission rates within 30 days of discharge following lung cancer surgery

26 September 2019
Lung Cancer
02 September 2019
Volume 28 · Issue 17

Abstract

Postoperative complications following curative lung cancer surgery are well recognised, but there is limited data on 30-day readmission rates. The UK Thoracic Surgery Group conducted a multicentre review over a 3-month period to assess readmission rates. Overall readmission among the 268 patients who had undergone primary lung cancer surgery was 30 (11%); 14/30 of readmissions occurred within 7 days of discharge, with 13/30 patients readmitted to a hospital that had not performed the surgery. The causes of readmission were mainly pulmonary related (16/30). Readmission was associated with being discharged with a pleural drain 11/30 (P<0.01), having two or more postoperative complications 11/30 (P<0.01) and a patient's readiness for discharge 9/30 (P=0.001). There was a trend toward an association with smoking 13/30 (P=0.18). The authors suggest that a greater focus on patients presenting with characteristics associated with readmission, and incorporating a patient's readiness for discharge, may reduce readmission, although more studies are needed.

Lung cancer is the third most common cancer in the UK, with 47 235 newly diagnosed cases recorded between 2014 and 2016 (Cancer Research UK, 2019). Surgery remains the first choice of curative treatment for individuals with stage 1 and stage 2 non-small cell lung cancer who are medically fit and who wish to have surgery (Lim et al, 2010). Between 2014 and 2015 the number of patients undergoing surgery in NHS hospitals in the UK rose from 5657 to 6000, an increase of 5% (Royal College of Physicians, 2017). Although postoperative complications are well recognised (Agostini et al, 2010; Stéphan et al, 2000), there is limited data that focuses on readmission rates following thoracic surgery.

Readmission to hospital after surgery impacts on patients' physical and psychological wellbeing while increasing health costs (Tsai et al, 2013). Studies that have explored readmission following pulmonary resection have primarily compared surgical technique (Freeman et al, 2013; Boffa et al, 2014), enhanced recovery programmes (Salati et al, 2012), the impact of postoperative pulmonary complications (Lugg et al, 2016) and length of hospital stay (Freeman et al, 2013).

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Lung cancer
Thoracic surgery
Discharge
30-day readmission