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. 2020 Aug;12(8):3949-3958.
doi: 10.21037/jtd-20-1474.

Perioperative fluid balance and 30-day unplanned readmission after lung cancer surgery: a retrospective study

Tak Kyu Oh  1 , Kwanmien Kim  2 , Jin-Hee Kim  1   3 , Sung-Hee Han  1   3 , Jung-Won Hwang  1   3
Affiliations

Perioperative fluid balance and 30-day unplanned readmission after lung cancer surgery: a retrospective study

Tak Kyu Oh et al. J Thorac Dis. 2020 Aug.

Abstract

Background: Perioperative positive fluid balance (FB) is associated with increased complications after lung resection surgery. However, its impact on the 30-day unplanned readmission rate is unclear. This study aimed to determine whether perioperative FB status during and up to 24 hours after lung resection surgery is associated with the 30-day unplanned readmission rate.

Methods: This retrospective cohort study examined adult patients aged 19 years or older who underwent lung cancer surgery at a single tertiary academic hospital between January 2005 and February 2018. Weight-based cumulative FB (%) was calculated during and up to 24 hours after surgery and was categorized as positive (≥5%), normal (0-5%), or negative (<0%). Univariable and multivariable logistic regression analyses were performed.

Results: The final analysis included 2,412 patients; 164 patients had unplanned readmission during the first 30 postoperative days (6.9%; 164/2,412). According to the multivariable logistic regression model, the positive FB group had a 2.42-time higher risk of 30-day unplanned readmission compared to the normal FB group [odds ratio (OR): 2.42; 95% confidence interval (CI): 1.20 to 4.89; P=0.014]. However, the risk of the negative FB group did not significantly differ from that of the normal FB group (OR: 1.20; 95% CI: 0.46 to 3.12; P=0.711).

Conclusions: Perioperative positive FB (>5%) during and up to 24 hours after surgery was associated with an increased 30-day unplanned readmission rate after lung cancer surgery. Future prospective studies are needed to confirm these findings.

Keywords: Hospitalization; lung neoplasms; thoracic surgery.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-1474). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Patient selection flowchart.
Figure 2
Figure 2
Odds ratios for 30-day unplanned readmissions among all individual variables in the multivariate model. Occupation [1]: professional (licensed job) vs. office worker; Occupation [2]: house work vs. office worker; Occupation [3]: self-employed vs. office worker; Occupation [4]: student, military, or laborer vs. office worker; Occupation [5]: unemployed vs. office worker. ASA, American Society of Anesthesiologists; CAD, coronary artery disease; FB, fluid balance.
Figure S1
Figure S1
Restricted cubic splines for log odds of 30-day unplanned readmissions according to cumulative FB during and up to 24 hours after surgery (%). FB, fluid balance.
See this image and copyright information in PMC

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