Time-varying analysis of readmission and mortality during the first year after pneumonectomy Conference Paper

Authors: Jones, G. D.; Tan, K. S.; Caso, R.; Dycoco, J.; Park, B. J.; Bott, M. J.; Molena, D.; Huang, J.; Isbell, J. M.; Bains, M. S.; Jones, D. R.; Rocco, G.
Title: Time-varying analysis of readmission and mortality during the first year after pneumonectomy
Conference Title: 99th Annual Meeting of the American Association for Thoracic Surgery (AATS)
Abstract: Objectives: Mortality rates of 5% to 10% after pneumonectomy have remained constant during the last decade. To understand the patterns of outcomes after pneumonectomy, we investigated the time-varying risks of readmission and death during the first postoperative year and examined the contributions of specific causes to these patterns over time. Methods: We retrospectively reviewed all pneumonectomies for lung cancer at our institution from 2000 to 2018. The time-varying instantaneous risk of all-cause readmission and mortality up to 1 year after pneumonectomy was estimated using parametric analyses and was repeated for each primary cause of readmission (oncologic, infectious, pulmonary, cardiac, or other) and death (oncologic or nononcologic). Results: In our cohort of 355 patients who underwent pneumonectomy, risk of readmission was highest immediately after discharge and was halved by 14 days. This risk reached a nadir and remained constant from 4 to 8 months, after which it gradually increased. Pulmonary causes accounted for most readmissions within 90 days, after which oncologic causes predominated. Likewise, the overall risk of death was highest immediately after surgery, was halved by 7 days, reached a nadir at 90 days, and then increased throughout the remainder of the first year. All deaths during the first 90 days after surgery were due to nononcologic causes. Conclusions: Nononcologic causes of readmission and death predominate in the first 90 days after pneumonectomy, after which oncologic causes prevail. We also identify specific causes that pose the highest risk of readmission immediately after discharge. Efforts are warranted to define the effects of specific causes of readmission on overall mortality after pneumonectomy. © 2020 The American Association for Thoracic Surgery
Keywords: treatment outcome; aged; middle aged; retrospective studies; mortality; lung resection; lung neoplasms; pneumonectomy; retrospective study; postoperative complication; postoperative complications; lung tumor; hospital readmission; adverse event; patient readmission; readmission; humans; human; male; female; oncologic; nononcologic
Journal Title Journal of Thoracic and Cardiovascular Surgery
Volume: 160
Issue: 1
Conference Dates: 2019 May 4-7
Conference Location: Toronto, Canada
ISBN: 0022-5223
Publisher: Mosby Elsevier  
Date Published: 2020-07-01
Start Page: 247
End Page: 255.e5
Language: English
DOI: 10.1016/j.jtcvs.2020.02.086
PUBMED: 32249082
PROVIDER: scopus
PMCID: PMC7348691
Notes: Conference Paper -- Export Date: 3 August 2020 -- Source: Scopus
Citation Impact
MSK Authors
  1. James Huang
    161 Huang
  2. Bernard J Park
    201 Park
  3. Matthew Bott
    82 Bott
  4. Joseph Dycoco
    33 Dycoco
  5. Manjit S Bains
    301 Bains
  6. David Randolph Jones
    290 Jones
  7. Daniela   Molena
    165 Molena
  8. Kay See   Tan
    166 Tan
  9. James Michael Isbell
    78 Isbell
  10. Gregory Jones
    20 Jones
  11. Raul Caso Jr
    19 Caso Jr
  12. Gaetano Rocco
    60 Rocco