Escalated grades of complications correlate with incremental costs of video‐assisted thoracoscopic surgery major lung resection for lung cancer in China

Abstract Objective Few studies have focused on factors associated with the incremental cost of video‐assisted thoracoscopic surgery (VATS) in China. We aim to systematically classify the complications after VATS major lung resection and explore their correlation with hospital costs. Methods Patients...

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Autores principales:	Ke Lan, Jian Zhou, Xizhao Sui, Jun Wang, Fan Yang
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	complications cost lung cancer video‐assisted thoracoscopy surgery Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/09ac5b80e2274894bc69fd953549ddb3
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spelling	oai:doaj.org-article:09ac5b80e2274894bc69fd953549ddb32021-11-14T23:28:25ZEscalated grades of complications correlate with incremental costs of video‐assisted thoracoscopic surgery major lung resection for lung cancer in China1759-77141759-770610.1111/1759-7714.14161https://doaj.org/article/09ac5b80e2274894bc69fd953549ddb32021-11-01T00:00:00Zhttps://doi.org/10.1111/1759-7714.14161https://doaj.org/toc/1759-7706https://doaj.org/toc/1759-7714Abstract Objective Few studies have focused on factors associated with the incremental cost of video‐assisted thoracoscopic surgery (VATS) in China. We aim to systematically classify the complications after VATS major lung resection and explore their correlation with hospital costs. Methods Patients with pathologically stage I–III lung cancer who underwent VATS major lung resections from January 2007 to December 2018 were included. The Thoracic Mortality and Morbidity (TM&M) Classification system was used to evaluate postoperative complications. Grade I and II complications, defined as minor complications, require no therapy or pharmacologic intervention only. Grade III and IV complications, defined as major complications, require surgical intervention or life support. Grade V results in death. A generalized linear model was used to explore the correlation of incremental hospital costs and complications, as well as other clinicopathologic parameters between 2013 and 2016. Results A total of 2881 patients were enrolled in the first part, and the minor and major complications rates were 24.3% (703 patients) and 8.3% (228 patients), respectively. Six hundred and eighty‐two patients were enrolled in the second part. The complications grade II (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.05–1.2, p = 0.0005), grade III (OR 1.55, 95% CI 1.26–1.9, p < 0.0001), grades IV and V (OR 1.09, 95% CI 1.04–1.13, p = 0.0002), diffusion capacity of carbon dioxide (OR 0.998, 95% CI 0.997–1.000, p = 0.004), and duration of chest drainage (OR 1.03, 95% CI 1.02–1.04, p < 0.001) and were independent risk factors for the increase in in‐hospital costs of VATS major lung resections. Conclusions The severity of complications graded by the TM&M system was an independent risk factor for increased in‐hospital costs.Ke LanJian ZhouXizhao SuiJun WangFan YangWileyarticlecomplicationscostlung cancervideo‐assisted thoracoscopy surgeryNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENThoracic Cancer, Vol 12, Iss 22, Pp 2981-2989 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	complications cost lung cancer video‐assisted thoracoscopy surgery Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	complications cost lung cancer video‐assisted thoracoscopy surgery Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Ke Lan Jian Zhou Xizhao Sui Jun Wang Fan Yang Escalated grades of complications correlate with incremental costs of video‐assisted thoracoscopic surgery major lung resection for lung cancer in China
description	Abstract Objective Few studies have focused on factors associated with the incremental cost of video‐assisted thoracoscopic surgery (VATS) in China. We aim to systematically classify the complications after VATS major lung resection and explore their correlation with hospital costs. Methods Patients with pathologically stage I–III lung cancer who underwent VATS major lung resections from January 2007 to December 2018 were included. The Thoracic Mortality and Morbidity (TM&M) Classification system was used to evaluate postoperative complications. Grade I and II complications, defined as minor complications, require no therapy or pharmacologic intervention only. Grade III and IV complications, defined as major complications, require surgical intervention or life support. Grade V results in death. A generalized linear model was used to explore the correlation of incremental hospital costs and complications, as well as other clinicopathologic parameters between 2013 and 2016. Results A total of 2881 patients were enrolled in the first part, and the minor and major complications rates were 24.3% (703 patients) and 8.3% (228 patients), respectively. Six hundred and eighty‐two patients were enrolled in the second part. The complications grade II (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.05–1.2, p = 0.0005), grade III (OR 1.55, 95% CI 1.26–1.9, p < 0.0001), grades IV and V (OR 1.09, 95% CI 1.04–1.13, p = 0.0002), diffusion capacity of carbon dioxide (OR 0.998, 95% CI 0.997–1.000, p = 0.004), and duration of chest drainage (OR 1.03, 95% CI 1.02–1.04, p < 0.001) and were independent risk factors for the increase in in‐hospital costs of VATS major lung resections. Conclusions The severity of complications graded by the TM&M system was an independent risk factor for increased in‐hospital costs.
format	article
author	Ke Lan Jian Zhou Xizhao Sui Jun Wang Fan Yang
author_facet	Ke Lan Jian Zhou Xizhao Sui Jun Wang Fan Yang
author_sort	Ke Lan
title	Escalated grades of complications correlate with incremental costs of video‐assisted thoracoscopic surgery major lung resection for lung cancer in China
title_short	Escalated grades of complications correlate with incremental costs of video‐assisted thoracoscopic surgery major lung resection for lung cancer in China
title_full	Escalated grades of complications correlate with incremental costs of video‐assisted thoracoscopic surgery major lung resection for lung cancer in China
title_fullStr	Escalated grades of complications correlate with incremental costs of video‐assisted thoracoscopic surgery major lung resection for lung cancer in China
title_full_unstemmed	Escalated grades of complications correlate with incremental costs of video‐assisted thoracoscopic surgery major lung resection for lung cancer in China
title_sort	escalated grades of complications correlate with incremental costs of video‐assisted thoracoscopic surgery major lung resection for lung cancer in china
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/09ac5b80e2274894bc69fd953549ddb3
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Escalated grades of complications correlate with incremental costs of video‐assisted thoracoscopic surgery major lung resection for lung cancer in China

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