The effect of osteopathic manipulative treatment on length of stay in posterolateral postthoracotomy patients: A retrospective case note study

Objective: This study retrospectively evaluated the effect of OMT on length of stay (LOS) in hospitalized posterolateral postthoracotomy patients. Methods: Inpatient medical records of patients who received posterolateral thoracotomies with lung resection between 1998 and 2011 were reviewed for demographic data, LOS, thoracotomy surgery data, consultation data excluding osteopathic manipulative medicine, discharge data, and osteopathic manipulative medicine consultation data. Results: Thirty-eight patients received posterolateral thoracotomies with lung resection; 23 patients received OMT and 15 did not. The mean (standard deviation) LOS was 11.0 (6.8) days (range, 5-29 days) for those who received OMT and 10.4 (5.5) days (range, 3-22 days) for those who did not (P=.90). Five patients developed postoperative ileus, and all had received OMT. Patients receiving 2 surgical procedures had a longer LOS than those receiving 1 surgical procedure (P=.002). Having a decortication performed during the thoracotomy increased LOS by a mean of 6.4 days (P=.005). Patients admitted directly to the intensive care unit were more likely to receive OMT than those who were not (P=.03). Conclusion: While there was no difference in LOS, severity of illness was different between patients who received OMT and those who did not. Patients who developed postoperative ileus and most of those admitted directly to the intensive care unit received OMT, suggesting that severity of illness was greater for those who received OMT. Future studies should include a higher subject number in order to stratify for illness severity and also assess the effect of OMT on postoperative pain. (C) 2014 The Authors. Published by Elsevier Ltd.