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  • Factors Associated with Ear...
    Maniscalco, Pio; Tamburini, Nicola; Fabbri, Nicolò; Quarantotto, Francesco; Rizzardi, Giovanna; Amore, Dario; Lopez, Camillo; Crisci, Roberto; Spaggiari, Lorenzo; Valpiani, Giorgia; Bertolaccini, Luca; Cavallesco, Giorgio; On Behalf Of The Vats Group

    Journal of clinical medicine, 12/2022, Letnik: 11, Številka: 24
    Journal Article

    Objective. There are limited data for estimating the risk of early discharge following thoracoscopic lobectomy. The objective was to identify the factors associated with a short length of stay and verify the influence of these variables in uncomplicated patients. Methods. We reviewed all lobectomies reported to the Italian VATS Group between January 2014 and January 2020. Patients and perioperative characteristics were divided into two subgroups based on whether or not they met the target duration of stay (≤ or >4 days). The association between preoperative and intraoperative variables and postoperative length of stay (LOS) ≤4 days was assessed using a stepwise multivariable logistic regression analysis to identify factors independently associated with LOS and factors related to LOS in uncomplicated cases. Results. Among 10,240 cases who underwent thoracoscopic lobectomy, 37.6% had a hospital stay ≤4 days. Variables associated with LOS included age, hospital surgical volume, Diffusion Lung CO % (81 69−94 vs. 85 73−98), Forced Expiratory Volume (FEV1) % (92 79−106 vs. 96 82−109), operative time (180 141−230 vs. 160 125−195), uniportal approach (571 9% vs. 713 18.5%), bioenergy sealer use, and pain control through intercostal block or opioids (p < 0.001). Except for FEV1 and blood loss, all other factors emerged significantly associated with LOS when the analysis was limited to uncomplicated patients. Conclusions. Demographic, clinical, and surgical variables are associated with early discharge after thoracoscopic lobectomy. This study indicates that these characteristics are associated with early discharge. This result can be used in association with clinical judgment to identify appropriate patients for fast-track protocols.