Evidence map›Paper›PMID 38204704›Full record

ArticleJTCVS open2023

Postoperative day 1 discharge following robotic thoracoscopic pulmonary anatomic resections in the era of enhanced recovery protocol: A single-institution experience.

Daniel J Gross, Ahmed Alnajar, Luis Miguel Cotamo, Michael Sarris-Michopoulos, Nestor R Villamizar, Dao M Nguyen

Open access · goldAbstract read
In one paragraph

Article in JTCVS open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Daniel J GrossDivision of Thoracic and Foregut Surgery, The DeWitt Daughtry Department of Surgery, The University of Miami, Miami, Fla.
Ahmed AlnajarDivision of Thoracic and Foregut Surgery, The DeWitt Daughtry Department of Surgery, The University of Miami, Miami, Fla.
Luis Miguel CotamoDivision of Thoracic and Foregut Surgery, The DeWitt Daughtry Department of Surgery, The University of Miami, Miami, Fla.
Michael Sarris-MichopoulosDivision of Thoracic and Foregut Surgery, The DeWitt Daughtry Department of Surgery, The University of Miami, Miami, Fla.
Nestor R VillamizarDivision of Thoracic and Foregut Surgery, The DeWitt Daughtry Department of Surgery, The University of Miami, Miami, Fla.
Dao M NguyenDivision of Thoracic and Foregut Surgery, The DeWitt Daughtry Department of Surgery, The University of Miami, Miami, Fla.
University of Miami · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Implementation and continuing optimization of enhanced recovery protocol after thoracic surgery results in significant improvement of postoperative outcomes. We observed a 10-fold increase in the rate of postoperative day (POD) 1 discharges following robotic thoracoscopic anatomic resections over time. We aimed to determine factors associated with safe POD1 discharges. Methods: We performed a retrospective analysis of a prospectively maintained database of robotic anatomic pulmonary resections between July 1, 2012, and June 30, 2022, with patients of the last 2.5 years forming the basis of this study. Data collected included demographics, insurance types, Area Deprivation Index (indicator of poverty), and operative and postoperative variables including length of stay, opioid use, daily pain levels, readmissions, and outpatient interventions. Factors associated with POD1 were analyzed using a logistic regression module. Result: In total, 279 patients met inclusion criteria (91 POD1 discharges, 32.6%; none discharged with a pleural catheter). There was neither an increase of postdischarge interventions for pleural complications nor readmission in early discharge patients. After adjusting for relevant factors, younger age, right middle lobectomy, lower opioid use on POD1, operating room finish before 4 PM, and low Area Deprivation Index were significantly associated with POD1 discharge. A subanalysis of 49 patients, who could have been discharged on POD1, identified hypoxemia requiring home oxygen, atrial fibrillation, and poorly controlled pain being common mitigatable clinical factors delaying POD1 discharge. Conclusions: Safe POD1 discharge following robotic thoracoscopic anatomic resection was achieved in 32% of cases. Identification of positive and negative factors affecting early discharge provides guidance for further modifications to increase the number of POD1 discharges.

Indexed as

anatomic pulmonary resectionearly discharge after lung resectionenhanced recovery after surgery protocolintercostal nerve blockliposomal bupivacaineopioidpostoperative opioid utilizationpostoperative painrobotic thoracic surgery

Identifiers

PMID38204704
PMCPMC10774976
OpenAlexW4385973144

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.