TY - JOUR
T1 - Variation in Pulmonary Resection Practices between the Society of Thoracic Surgeons and the European Society of Thoracic Surgeons General Thoracic Surgery Databases
AU - Seder, Christopher W.
AU - Salati, Michele
AU - Kozower, Benjamin D.
AU - Wright, Cameron D.
AU - Falcoz, Pierre Emmanuel
AU - Brunelli, Alessandro
AU - Fernandez, Felix G.
N1 - Publisher Copyright:
© 2016 The Society of Thoracic Surgeons.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background Clinical guidelines are created to reduce variation in care practices, with the goal of improving patient outcomes. There is currently no international consensus on best practices for pulmonary resection. Our aim was to evaluate variation in treatment patterns and outcomes for pulmonary resection by comparing The Society of Thoracic Surgeons (STS) and the European Society of Thoracic Surgery (ESTS) general thoracic surgery databases (GTSDs). Methods An international collaboration was established between the STS and ESTS GTSD task forces. Patients who underwent pulmonary resection between 2010 and 2013 were identified from the 2 databases. Data on patient demographics, disease characteristics, treatment strategies, morbidity, and mortality were compared. Results There were 78,212 lung resections captured in the STS (n = 47,539) and ESTS databases (n = 30,673). Patients from the STS database were more likely to be of the female sex, have no pathologic N2 disease, have had previous cardiothoracic operations, and have received preoperative thoracic irradiation compared with patients from the ESTS database. In addition, patients from the STS database were more likely to have undergone a thoracoscopic operation and have received a sublobar resection. Although there was an increased risk of reintubation, atrial arrhythmias, and return to the operating room in the STS patients, the mean hospital length of stay was shorter than in patients from the ESTS database, regardless of operation performed. Thirty-day mortality was higher in the STS patients for wedge resection (p < 0.001) but lower for lobectomy (p < 0.001) and pneumonectomy (p < 0.001) compared with the ESTS patients. Conclusions Differences exists in patient population, procedures performed, and outcomes for pulmonary resections between the STS and ESTS databases, suggesting an opportunity for quality improvement initiatives.
AB - Background Clinical guidelines are created to reduce variation in care practices, with the goal of improving patient outcomes. There is currently no international consensus on best practices for pulmonary resection. Our aim was to evaluate variation in treatment patterns and outcomes for pulmonary resection by comparing The Society of Thoracic Surgeons (STS) and the European Society of Thoracic Surgery (ESTS) general thoracic surgery databases (GTSDs). Methods An international collaboration was established between the STS and ESTS GTSD task forces. Patients who underwent pulmonary resection between 2010 and 2013 were identified from the 2 databases. Data on patient demographics, disease characteristics, treatment strategies, morbidity, and mortality were compared. Results There were 78,212 lung resections captured in the STS (n = 47,539) and ESTS databases (n = 30,673). Patients from the STS database were more likely to be of the female sex, have no pathologic N2 disease, have had previous cardiothoracic operations, and have received preoperative thoracic irradiation compared with patients from the ESTS database. In addition, patients from the STS database were more likely to have undergone a thoracoscopic operation and have received a sublobar resection. Although there was an increased risk of reintubation, atrial arrhythmias, and return to the operating room in the STS patients, the mean hospital length of stay was shorter than in patients from the ESTS database, regardless of operation performed. Thirty-day mortality was higher in the STS patients for wedge resection (p < 0.001) but lower for lobectomy (p < 0.001) and pneumonectomy (p < 0.001) compared with the ESTS patients. Conclusions Differences exists in patient population, procedures performed, and outcomes for pulmonary resections between the STS and ESTS databases, suggesting an opportunity for quality improvement initiatives.
UR - http://www.scopus.com/inward/record.url?scp=84961820437&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2015.12.073
DO - 10.1016/j.athoracsur.2015.12.073
M3 - Article
C2 - 27021033
AN - SCOPUS:84961820437
SN - 0003-4975
VL - 101
SP - 2077
EP - 2084
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 6
ER -