HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Memtsoudis, S. G. Articles by Rogers, S. O. Search for Related Content PubMed PubMed Citation Articles by Memtsoudis, S. G. Articles by Rogers, S. O.

Trends in Lung Surgery^*

United States 1988 to 2002

^* From the Department of Anesthesiology, Perioperative, and Pain Medicine (Dr. Memtsoudis), the Department of Surgery (Dr. Zellos), Division of Thoracic Surgery, and Department of Surgery (Drs. Patil and Rogers), Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA; and Mathematica Policy Research, Inc (Dr. Besculides), Cambridge, MA.

Correspondence to: Stavros G. Memtsoudis MD, PhD, Hospital for Special Surgery, Department of Anesthesiology, 535 East 70th St, New York, NY 10021; e-mail: memtsoudiss{at}hss.edu

Abstract

Background: Reports on the temporal evolution in lung resection are limited. To elucidate temporal changes in the demographics of lung resections, we analyzed nationally representative data that were collected for the National Hospital Discharge Survey from 1988 to 2002.

Methods: Data collected between 1988 and 2002 were analyzed. Patients with International Classification of Diseases, ninth revision, clinical modification, procedure codes for lung resection were included in the sample. Three 5-year time periods were created (1988 to 1992, 1993 to 1997, and 1998 to 2002) to simplify the temporal analysis. Changes in the prevalence of procedures, age, gender, race, length of care, mortality, disposition status, and distribution by hospital size were evaluated. Trends in procedure-related complications were analyzed.

Results: Between 1988 and 2002, a total of 512,758 lung resections were performed. Comparing the earliest to the most recent time period, we found increases in the average age (61.1 years [range, 1 to 89 years] vs 63.2 years [range, 1 to 91 years], respectively), in the proportion of patients who were female (40.1% vs 49.6%, respectively), and in the proportion of Medicare/Medicaid patients (43.8% vs 49%/4.7% vs 6.7%, respectively). Decreases in the average length of stay (12.9 days [range, 1 to 358 days] vs 9.1 days [range, 1 to 175 days], respectively) and in the proportion of patients discharged to their primary residence (86% vs 79.5%, respectively) were seen. The proportion of patients who had undergone lobectomies compared to other types of lung resection increased. Mortality rates were 5% vs 5.4%, respectively, while the frequency of complications decreased.

Conclusion: We identified temporal changes in lung resection surgery that may help in the construction of health-care policies to address the changing needs of and financial burdens on the health-care system.

Key Words: epidemiology • lung • surgery