Outcomes and Medical Utilization for Lung Cancer Patients Undergoing Surgery

Purpose: Lung cancer belongs to the top ten death causes, ranking the second position. There were few systemic studies focus on the operation and medical resources for the patients. The purpose of the study was to evaluate the impact factors such as in-hospital days and the using of the medical facilities after 6-month discharge from the hospital for the lung cancer patient who underwent the surgical intervention. We also examined the factors which influence the mid-term and long-term follow up for the patients.

Methods:

This was a retrospective study involving a single medical center in southern Taiwan. Between Jan 2008 to Dec 2012, we collected the primary lung cancer patients receiving the first surgical intervention.   Data analysis was divided to two parts, chart review and the data base from our ministry of health. Dichotomous variables were evaluated

with 2 analysis to define various patient groups contributing significantly to in-hospital mortality. Risk factors were determined using univariate analysis. Only those variables that reached p < 0.05 were considered for the model. Once we identified these potential risk factors, a multivariate stepwise logistic regression analysis was done to identify independent predictors. Statistical significance was set at p < 0.05. SPSS 19.0 (SPSS Inc., Chicago, IL, USA) was used for all statistical analysis Only those variables that reached p < 0.05 were considered for the model.

Results: There were 207 patients enrolled in our study with an average of 63.1 years old, male dominant (58.1%), adenocarcinoma dominant (57%), complication rate of 45.4%. Operation methods were thoracoscopy  dominant (79.1%) and lung lobectomy dominant (47.8%). Average operation time and in-hospital days were 322 mins and 15.5 days, respectively. Recurrence rate was 26.6%. Different operation methods were highly influenced to different results. The complication rate had statistically significance to operation time, in-hospital days and chest tube time. Different operation methods were related to in-hospital days, blood loss amount, ICU days and chest tube time. Gender, severity of the diseases, lung function, different operation had relationship to in-hospital days. Mortality was influenced by the degree of lung obstruction, recurrence, ICU days, chest tube time, in-hospital days and operation methods.

Conclusion: Different operations lead to different results. Gender, the severity of diseases, lung function, operation methods have effects on using the medical resources. We recommended precise evaluation of age, physical status, operation methods for patients in order to reducing the operative complications and the wasting the medical resources. With the developments of medical technology, we believe the results may provide some suggestions to the policy maker and medical service provider.