28 Ago Operating room scheduling is not associated with early outcome following elective anatomic lung resections: a propensity score case-matched analysis.

Patella M, Papagiannopoulos K, Milton R, Chaudhuri N, Kefaloyannis E, Brunelli A.

Eur J Cardiothorac Surg. 2017 Apr 1;51(4):660-666

OBJECTIVES:

To investigate the effect of operating room scheduling on the outcome of patients undergoing elective lung resection.

METHODS:
In total, 420 patients submitted to anatomical pulmonary resections (363 lobectomies, 35 pneumonectomies, 22 segmentectomies) (April 2014-November 2015) were analysed. Ninety-two patients (22%) were operated on during weekends (Friday or Saturday) and 161 patients (38%) in the afternoon. Propensity score matching was performed to account for possible selection bias between the groups. The matched groups (weekdays versus weekends; morning versus afternoon) were compared in terms of cardiopulmonary complications, in-hospital mortality and length of stay (LOS).

RESULTS:
In total, 102 (24%) patients developed cardiopulmonary complications and 56 (13%) patients developed major complications. In-hospital mortality was 3.1% (13 patients). The case-matched comparison between patients operated on during the week versus those operated on during weekends (92 pairs) showed no differences of cardiopulmonary morbidity (22 vs 24, P  = 0.8), major complications (14 in both groups), mortality (2 vs 4, P  = 0.7) and LOS (7 vs 7.5 days, P  = 0.6). The case-matched comparison between patients operated on in the morning versus those operated on in the afternoon (161 pairs) showed no differences of cardiopulmonary morbidity (32 vs 33, P  = 0.9), major morbidity (17 vs 19, P  = 1), mortality (7 vs 4, P  = 0.5) and LOS (7.2 vs 5.9 days, P  = 0.2).

CONCLUSIONS:
In our setting, operating room scheduling did not affect early outcome following elective lung resections, confirming the appropriate structural and procedural characteristics of a dedicated Thoracic Unit.