Escalated grades of complications correlate with incremental costs of video-assisted thoracoscopic surgery major lung resection for lung cancer in China

被引:4
|
作者
Lan, Ke [1 ]
Zhou, Jian [1 ]
Sui, Xizhao [1 ]
Wang, Jun [1 ]
Yang, Fan [1 ]
机构
[1] Peking Univ Peoples Hosp, Dept Thorac Surg, 11 Xizhimen South St, Beijing 100044, Peoples R China
关键词
complications; cost; lung cancer; video-assisted thoracoscopy surgery; THORACIC-SURGERY; LOBECTOMY; CLASSIFICATION; THORACOTOMY; MORBIDITY; MODEL;
D O I
10.1111/1759-7714.14161
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective Few studies have focused on factors associated with the incremental cost of video-assisted thoracoscopic surgery (VATS) in China. We aim to systematically classify the complications after VATS major lung resection and explore their correlation with hospital costs. Methods Patients with pathologically stage I-III lung cancer who underwent VATS major lung resections from January 2007 to December 2018 were included. The Thoracic Mortality and Morbidity (TM&M) Classification system was used to evaluate postoperative complications. Grade I and II complications, defined as minor complications, require no therapy or pharmacologic intervention only. Grade III and IV complications, defined as major complications, require surgical intervention or life support. Grade V results in death. A generalized linear model was used to explore the correlation of incremental hospital costs and complications, as well as other clinicopathologic parameters between 2013 and 2016. Results A total of 2881 patients were enrolled in the first part, and the minor and major complications rates were 24.3% (703 patients) and 8.3% (228 patients), respectively. Six hundred and eighty-two patients were enrolled in the second part. The complications grade II (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.05-1.2, p = 0.0005), grade III (OR 1.55, 95% CI 1.26-1.9, p < 0.0001), grades IV and V (OR 1.09, 95% CI 1.04-1.13, p = 0.0002), diffusion capacity of carbon dioxide (OR 0.998, 95% CI 0.997-1.000, p = 0.004), and duration of chest drainage (OR 1.03, 95% CI 1.02-1.04, p < 0.001) and were independent risk factors for the increase in in-hospital costs of VATS major lung resections. Conclusions The severity of complications graded by the TM&M system was an independent risk factor for increased in-hospital costs.
引用
收藏
页码:2981 / 2989
页数:9
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