• Marcus Taylor, Richard Templeton, Felice Granato, Thomas Eadington, Rajesh Shah, and Stuart W Grant.
• Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester University Hospital Foundation Trust, Manchester, United Kingdom. Electronic address: marcus.taylor1@nhs.net.
• J. Cardiothorac. Vasc. Anesth. 2022 Aug 1; 36 (8 Pt A): 2393-2399.

ObjectivesDespite an increasing proportion of patients undergoing lung resection being managed postoperatively in a ward-based environment, studies analyzing the impact of initial postoperative destination (IPD) on perioperative outcomes and unplanned critical care admission (UCCA) are lacking.DesignA single-center retrospective review.SettingA cardiothoracic surgery center in the Northwest of England.ParticipantsA total of 3,841 patients between 2012 and 2018.InterventionsAll patients underwent lung resection. Patients were classified as either IPD ward or IPD critical care.Measurements And Main ResultsOutcomes assessed included in-hospital and 90-day mortality and UCCA. Differences in mortality rates between groups were assessed using the chi-square test. Multivariate logistic regression analyses were performed to identify variables independently associated with 90-day mortality and UCCA. In total, 23.8% (n = 913) of patients went to critical care as their IPD. Overall in-hospital mortality was 1.6% (n = 62), and 90-day mortality was 2.9% (n = 112). The rate of UCCA was 10.5% (n = 404) and was significantly higher for IPD ward patients compared to IPD critical care patients (11.9% v 6.2%, p < 0.001). The 90-day mortality rates after UCCA were 5.2% (IPD ward) and 19.3% (IPD critical care) (p < 0.001). Advanced age, worse pulmonary function, IPD ward, and timing of surgery were all independently associated with UCCA.ConclusionsMost patients undergoing lung resection can be managed safely postoperatively in a ward-based environment. Short-term mortality is higher after UCCA, with patients who experience readmission to critical care at the highest risk of death. Patients should receive additional monitoring immediately following discharge from critical care.Copyright © 2022 Elsevier Inc. All rights reserved.

10 keywords...

hide…