ArticleInterdisciplinary cardiovascular and thoracic surgery2025
Temporal Trends in Outcomes and Predictors of Length of Stay following Lung Cancer Resection over 10 Years with Enhanced Recovery After Surgery.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Robotic surgery for pulmonary sequestration: interpreting early advantages.General thoracic and cardiovascular surgery · 2026Article
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13 authors.
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Abstract
objectivesEnhanced Recovery After Surgery aims to accelerate recovery, with length of stay as a key metric. This study assessed temporal trends in short-term outcomes within a maturing programme and identified factors associated with increased hospital stay.
methodsData were prospectively collected for consecutive patients undergoing lung cancer resection following a 14-step protocol between 2013 and 2023. Primary outcome was length of stay. Secondary outcomes included 30-day mortality, morbidity, re-admission, and reoperation rates. Predictors of length of stay were analysed using linear regression.
resultsWe included 2192 patients; procedures included lobectomy (61%), wedge resection (23%), segmentectomy (10%), pneumonectomy (3.5%), and bi-lobectomy (2.7%), Video-assisted thoracoscopic surgery was used in 80% of cases. Median length of stay decreased from 5 to 4 days (p < 0.001), while protocol adherence increased from 10/14 to 12/14 (p = 0.01). In-hospital mortality (2.9% to 1.0%, p < 0.001) and major-morbidity (12.2% to 5.6%, p < 0.001) both declined. In multivariable linear regression, factors associated with longer stay included age (β = 0.17, CI 0.13-0.20, p < 0.001), higher American Society of Anesthesiologists score (β = 1.12, CI 1.04-2.2, p = 0.02), open surgery (β = 1.0, CI 0.17-2.2, p = 0.043), thoracoscopic-to-open converted surgery (β = 1.49, CI 0.96-1.9, p = 0.03) and intensive care (β = 3.4, CI 2.5-4.3, p < 0.001). Protective factors were early mobilisation (β=-0.90, CI -1.9-0.33, p = 0.005) and opioid avoidance (β=-0.72, CI -2.4-0.99, p = 0.038).
conclusionsSustained use of an Enhanced Recovery After Surgery programme was associated with shorter hospitalisation and reduced morbidity. Factors associated with length of stay can identify patients at risk of delayed recovery and prioritise elements for optimisation within recovery pathways.
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