Predictors for 30-day readmission after pulmonary resection for lung cancer

Background: The purpose of this study was to assess the rate, cause, and factors associated with readmissions following pulmonary resection for lung cancer and their relationship with 90-day mortality. Methods: A prospective cohort study was conducted of 379 patients who underwent surgery for lung cancer at the university hospitals Granada, Spain between 2012 and 2016. Results: The rate of readmissions within 30 postoperative days was 6.2%. The most common reason for readmission was subcutaneous emphysema (21.7%), pneumonia (13%), and pleural empyema (8.5%). A higher probability of requiring urgent readmission was associated with a higher Charlson index (OR 2.0,95% confidence interval 1.50-2.67, P=0.001); peripheral arterial vasculopathy (OR 4.8, 95%CI 1.27-18.85, P=0.021); a history of stroke (OR 8.2, 95%CI 1.08-62.37, P=0.04); postoperative atelectasis (OR 4.7, 95%CI 1.21-18.64, P=0.026); and air leaks (OR 12.6, 95%CI 4.10-38.91, P=0.001).The prediction multivariable model for readmission represents an area under the curve (ROC) of 0.90. Mortality at 90 postoperative days in the group of readmitted patients was 13% versus 1.5 for the group of patients who did not require readmission (P<0.001). Conclusions: The factors predictive for readmission can help design individualized outpatient follow-up plans and programs for the reduction of readmissions.