Impact That Day of the Week has on Length of Stay for Video-assisted Lobectomy

S S. Pupovac, Northwell Health
P C. Lee
J Jurado, Zucker School of Medicine at Hofstra/Northwell
K Hyman, Zucker School of Medicine at Hofstra/Northwell
L Glassman
D Zeltsman, Zucker School of Medicine at Hofstra/Northwell

Abstract

We aimed to analyze the effect that the day of the week for video-assisted thoracoscopic surgery lobectomy has on length of stay. A retrospective review identified all patients who underwent video-assisted thoracoscopic surgery lobectomy at a single institution from January 2016 to July 2017. In total, 208 patients were divided into 2 groups based on timing of their operation: Operations performed on Monday, Tuesday, or Wednesday were defined as “early in the week” and those performed on Thursday or Friday were defined as “late in the week.” We then propensity-matched 81 pairs of patients and analyzed perioperative data and short-term clinical outcomes. A total of 208 patients underwent video-assisted thoracic surgery lobectomy during the study period. Length of stay was significantly decreased by 2.0 days (P <0.0001) for all lobectomies performed “early in the week” compared with those performed “late in the week.” Thirty-day mortality and all major morbidities did not significantly different between the 2 matched groups. Our findings suggest that major pulmonary resections should be performed early in the week, when feasible, to facilitate utilization of hospital resources and prompt discharge.