2018
Identifying Drivers of Multiple Readmissions After Pulmonary Lobectomy
Jean RA, Chiu AS, Hoag JR, Blasberg JD, Boffa DJ, Detterbeck FC, Kim AW. Identifying Drivers of Multiple Readmissions After Pulmonary Lobectomy. The Annals Of Thoracic Surgery 2018, 107: 947-953. PMID: 30336117, DOI: 10.1016/j.athoracsur.2018.08.070.Peer-Reviewed Original ResearchConceptsPulmonary lobectomyMultiple readmissionsSecond readmissionFirst readmissionIndex hospitalizationPostoperative infectionLung cancerPrimary diagnosisHeart diseaseClinical Classification Software codesNationwide Readmissions DatabaseTime of readmissionPostoperative arrhythmiasPostoperative complicationsPostoperative sepsisPerioperative periodPostoperative periodClinical factorsReadmissionLobectomyPatientsStudy periodImportant markerDiagnosisHealthcare qualityDefining the learning curve in robot-assisted thoracoscopic lobectomy
Arnold BN, Thomas DC, Bhatnagar V, Blasberg JD, Wang Z, Boffa DJ, Detterbeck FC, Kim AW. Defining the learning curve in robot-assisted thoracoscopic lobectomy. Surgery 2018, 165: 450-454. PMID: 30061043, DOI: 10.1016/j.surg.2018.06.011.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlood Loss, SurgicalFemaleHumansLearning CurveLength of StayLinear ModelsMaleOperative TimePneumonectomyPostoperative ComplicationsRobotic Surgical ProceduresThoracoscopyConceptsLength of stayRobot-assisted thoracoscopic lobectomyChest tube durationThoracoscopic lobectomyPostoperative complicationsTube durationBlood lossLearning curveSignificant differencesCumulative sum analysisPhase 1Complication ratePatient demographicsPulmonary lobectomySingle institutionLobectomyRATS lobectomySafe approachStayCase 1Cases 23Operating timeComorbiditiesComplicationsFurther studiesWhen good operations go bad: The additive effect of comorbidity and postoperative complications on readmission after pulmonary lobectomy
Jean RA, Chiu AS, Boffa DJ, Detterbeck FC, Blasberg JD, Kim AW. When good operations go bad: The additive effect of comorbidity and postoperative complications on readmission after pulmonary lobectomy. Surgery 2018, 164: 294-299. PMID: 29801731, DOI: 10.1016/j.surg.2018.03.019.Peer-Reviewed Original ResearchConceptsPostoperative complicationsReadmission ratesPulmonary lobectomyAdditional comorbiditiesThoracic surgeryCause readmission rateDays of dischargeNationwide Readmissions DatabaseNumber of comorbiditiesRisk of readmissionMajor thoracic surgeryProbability of readmissionLow risk profileHealth care deliveryHospital factorsHospital readmissionLow comorbidityElixhauser comorbiditiesThoracic lobectomyLung cancerPrimary diagnosisChronic diseasesHigh burdenMean changeValue-based reimbursementTiming and Risk Factors Associated With Venous Thromboembolism After Lung Cancer Resection
Thomas DC, Arnold BN, Hoag JR, Salazar MC, Detterbeck FC, Boffa DJ, Kim AW, Blasberg JD. Timing and Risk Factors Associated With Venous Thromboembolism After Lung Cancer Resection. The Annals Of Thoracic Surgery 2018, 105: 1469-1475. PMID: 29501644, DOI: 10.1016/j.athoracsur.2018.01.072.Peer-Reviewed Original ResearchConceptsPostdischarge venous thromboembolismVenous thromboembolismHospital dischargeOperative timeRisk factorsPostdischarge prophylaxisVTE eventsMultivariable analysisLung cancerNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseExtended VTE prophylaxisLung cancer resectionImprovement Program databaseShorter operative timeLengthy resectionsVTE prophylaxisAnatomic resectionClinical characteristicsInvasive resectionLung resectionOlder patientsOpen resectionCancer resectionIndependent predictors
2017
Validating the Thoracic Revised Cardiac Risk Index Following Lung Resection
Thomas DC, Blasberg JD, Arnold BN, Rosen JE, Salazar MC, Detterbeck FC, Boffa DJ, Kim AW. Validating the Thoracic Revised Cardiac Risk Index Following Lung Resection. The Annals Of Thoracic Surgery 2017, 104: 389-394. PMID: 28499655, DOI: 10.1016/j.athoracsur.2017.02.006.Peer-Reviewed Original ResearchConceptsAdditional cardiac evaluationIschemic heart diseaseLarger multi-institutional datasetsCardiac complicationsLung resectionRenal comorbiditiesCardiac evaluationCerebrovascular diseaseHeart diseaseRisk factorsMulti-institutional datasetSurgeons National Surgical Quality Improvement Program datasetNational Surgical Quality Improvement Program datasetCardiac complication ratesMajor cardiac complicationsPreoperative risk factorsUnderwent pneumonectomyCardiac indexComplication ratePrimary outcomeRisk classesMalignant diseaseOpen procedureAmerican CollegeHigh risk
2016
Hospital Volume and Outcomes of Robot-Assisted Lobectomies
Tchouta LN, Park HS, Boffa DJ, Blasberg JD, Detterbeck FC, Kim AW. Hospital Volume and Outcomes of Robot-Assisted Lobectomies. CHEST Journal 2016, 151: 329-339. PMID: 27687847, DOI: 10.1016/j.chest.2016.09.008.Peer-Reviewed Original ResearchMeSH KeywordsAgedCase-Control StudiesCohort StudiesDatabases, FactualFemaleHospital MortalityHospitals, High-VolumeHospitals, Low-VolumeHumansLength of StayLinear ModelsLogistic ModelsLungLung NeoplasmsMaleMiddle AgedMultivariate AnalysisPneumonectomyPostoperative ComplicationsRetrospective StudiesRobotic Surgical ProceduresThoracic Surgery, Video-AssistedTreatment OutcomeConceptsLength of stayLow-volume centersHospital volumeClinical impactHealth care system-related factorsShorter mean LOSUtilization Project National Inpatient Sample databaseVolume/outcome relationshipLong-term clinical impactMean LOSNational Inpatient Sample databaseShorter LOSVideo-assisted thoracoscopic surgeryHospital operative volumeHigh-volume hospitalsIncidence of complicationsHigher hospital volumeThoracoscopic surgery lobectomyAnnual case volumeSystem-related factorsOutcomes of interestLOS outcomesInfectious complicationsInpatient mortalityIndependent predictorsThe differential impact of preoperative comorbidity on perioperative outcomes following thoracoscopic and open lobectomies
Jawitz OK, Wang Z, Boffa DJ, Detterbeck FC, Blasberg JD, Kim AW. The differential impact of preoperative comorbidity on perioperative outcomes following thoracoscopic and open lobectomies. European Journal Of Cardio-Thoracic Surgery 2016, 51: 169-174. PMID: 27458143, DOI: 10.1093/ejcts/ezw239.Peer-Reviewed Original ResearchConceptsNationwide Inpatient SampleOpen lobectomyPostoperative lengthVATS lobectomyLobectomy patientsVideo-assisted thoracoscopic surgery lobectomyBenign lung conditionsOpen lobectomy patientsPerioperative pulmonary complicationsVATS lobectomy patientsNumber of comorbiditiesNon-elective admissionsCell lung cancerMultivariable logistic regressionThoracoscopic surgery lobectomyStandard of careUtilization Project databasePreoperative patient comorbiditiesCumulative incidence modelsLogistic regression modellingHospital mortalityPreoperative comorbiditiesPulmonary complicationsGreater comorbidityPerioperative outcomesEstimating the Annual Incremental Cost of Several Complications Following Pulmonary Lobectomy
Jawitz OK, Boffa DJ, Detterbeck FC, Wang Z, Kim AW. Estimating the Annual Incremental Cost of Several Complications Following Pulmonary Lobectomy. Seminars In Thoracic And Cardiovascular Surgery 2016, 28: 531-540. PMID: 28043473, DOI: 10.1053/j.semtcvs.2016.06.001.Peer-Reviewed Original ResearchConceptsAcute respiratory failureLength of hospitalizationPulmonary lobectomyHospital stayRespiratory failureMajor complicationsAir leakAnnual health care expendituresRetrospective cohort analysisNational Inpatient SampleLength of stayPostoperative air leaksUtilization Project databaseAnnual incremental costMultivariable quantile regression modelsAggregate national costHealth care expendituresHealth care qualityLarge national datasetCommon complicationVATS lobectomyCostly complicationInpatient SampleHospital costsClinical dataAnalyzing Risk Factors for Morbidity and Mortality after Lung Resection for Lung Cancer Using the NSQIP Database
Jean RA, DeLuzio MR, Kraev AI, Wang G, Boffa DJ, Detterbeck FC, Wang Z, Kim AW. Analyzing Risk Factors for Morbidity and Mortality after Lung Resection for Lung Cancer Using the NSQIP Database. Journal Of The American College Of Surgeons 2016, 222: 992-1000.e1. PMID: 27118714, DOI: 10.1016/j.jamcollsurg.2016.02.020.Peer-Reviewed Original ResearchConceptsPreoperative risk factorsAnatomic pulmonary resectionMultivariate logistic regressionRisk factorsPreoperative dyspneaPulmonary resectionLogistic regressionNSQIP databaseMultivariate logistic regression modelingIntraoperative risk factorsRetrospective cohort studyDay of surgerySurgeons NSQIP databaseLogistic regression modelingLogistic regression modelsElective lobectomyPreoperative anemiaPerioperative complicationsPerioperative mortalityPostoperative complicationsLung resectionClinical factorsCohort studyMale sexOpen lobectomy
2014
Fewer complications result from a video-assisted approach to anatomic resection of clinical stage I lung cancer
Boffa DJ, Dhamija A, Kosinski AS, Kim AW, Detterbeck FC, Mitchell JD, Onaitis MW, Paul S. Fewer complications result from a video-assisted approach to anatomic resection of clinical stage I lung cancer. Journal Of Thoracic And Cardiovascular Surgery 2014, 148: 637-643. PMID: 24529729, DOI: 10.1016/j.jtcvs.2013.12.045.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overFemaleHumansLogistic ModelsLung NeoplasmsMaleMiddle AgedMultivariate AnalysisNeoplasm StagingOdds RatioPneumonectomyPostoperative ComplicationsPropensity ScoreRisk FactorsThoracic Surgery, Video-AssistedThoracotomyTime FactorsTreatment OutcomeYoung AdultConceptsStage I lung cancerClinical stage I lung cancerI lung cancerThoracic Surgeons databaseAnatomic resectionLung cancerSurgeons databaseStage I primary lung cancerVideo-assisted thoracic surgery approachEarly-stage lung cancerMore pulmonary complicationsClinical stage ILung cancer resectionPrimary lung cancerMorbidity of patientsThoracic surgery approachStage lung cancerStandard of careMorbidity of thoracotomyVideo-assisted approachLower mortality rateOverall complicationsPulmonary complicationsThoracotomy groupVATS cohort
2013
Minimally invasive oesophagectomy more expensive than open despite shorter length of stay†
Dhamija A, Dhamija A, Hancock J, McCloskey B, Kim AW, Detterbeck FC, Boffa DJ. Minimally invasive oesophagectomy more expensive than open despite shorter length of stay†. European Journal Of Cardio-Thoracic Surgery 2013, 45: 904-909. PMID: 24092502, DOI: 10.1093/ejcts/ezt482.Peer-Reviewed Original ResearchMeSH KeywordsAgedEsophagectomyFemaleHumansLength of StayMaleMiddle AgedMinimally Invasive Surgical ProceduresPostoperative ComplicationsRetrospective StudiesConceptsOpen transthoracicInvasive oesophagectomyOesophageal cancerHigher surgical expenseShorter hospital stayDay of surgeryTotal hospital costsGreater overall costsMIO groupMIO patientsSurgical expensesHospital stayOperative mortalityEntire hospitalizationTranshiatal approachInpatient hospitalizationHealth care economyOpen groupHospital costsShorter lengthInvasive approachTheatre costsBaseline statusInvasive proceduresMedian costPulmonary resections following prior definitive chemoradiation therapy are associated with acceptable survival
Kuzmik GA, Detterbeck FC, Decker RH, Boffa DJ, Wang Z, Oliva IB, Kim AW. Pulmonary resections following prior definitive chemoradiation therapy are associated with acceptable survival. European Journal Of Cardio-Thoracic Surgery 2013, 44: e66-e70. PMID: 23557918, DOI: 10.1093/ejcts/ezt184.Peer-Reviewed Original ResearchMeSH KeywordsAgedChemoradiotherapyFemaleHumansLung NeoplasmsMaleMiddle AgedPneumonectomyPostoperative ComplicationsRetrospective StudiesSalvage TherapySurvival AnalysisConceptsDefinitive chemoradiation therapySalvage lung resectionChemoradiation therapyLung resectionPostoperative survivalCurative-intent chemoradiation therapyMultivariate Cox proportional modelMedian disease-free intervalLung cancer resectionRecurrent lung cancerDisease-free intervalCox proportional modelsLung cancer recurrenceDefinitive chemoradiationPerioperative deathsSalvage resectionComplication ratePulmonary resectionCancer resectionDefinitive treatmentImproved survivalLung cancerCancer stageMedical recordsCancer recurrence
2012
Stereotactic Body Radiotherapy for Central Lung Tumors
Rowe BP, Boffa DJ, Wilson LD, Kim AW, Detterbeck FC, Decker RH. Stereotactic Body Radiotherapy for Central Lung Tumors. Journal Of Thoracic Oncology 2012, 7: 1394-1399. PMID: 22843088, DOI: 10.1097/jto.0b013e3182614bf3.Peer-Reviewed Original ResearchConceptsStereotactic body radiotherapyCentral lung tumorsBiological equivalent doseLocal recurrenceTracheobronchial treeLung tumorsBody radiotherapyCentral lesionsEquivalent doseGrade 3Baseline pulmonary function testsLarger maximum tumor diameterMedian biological equivalent doseChest wall painGrade 3 dyspneaYale Cancer CenterGrade 2 toxicityLocal control ratePrimary lung cancerPulmonary function testsHigh-grade toxicityMajority of patientsVolume of lungMaximum tumor diameterMaximum point doseCharacteristics Associated With the Use of Nonanatomic Resections Among Medicare Patients Undergoing Resections of Early-Stage Lung Cancer
Kim AW, Detterbeck FC, Boffa DJ, Decker RH, Soulos PR, Cramer LD, Gross CP. Characteristics Associated With the Use of Nonanatomic Resections Among Medicare Patients Undergoing Resections of Early-Stage Lung Cancer. The Annals Of Thoracic Surgery 2012, 94: 895-901. PMID: 22835558, PMCID: PMC3501201, DOI: 10.1016/j.athoracsur.2012.04.091.Peer-Reviewed Original ResearchMeSH KeywordsAge DistributionAgedAged, 80 and overCarcinoma, Non-Small-Cell LungConfidence IntervalsDisease-Free SurvivalEthnicityFemaleHumansLogistic ModelsLungLung NeoplasmsMaleMedicareMultivariate AnalysisNeoplasm InvasivenessNeoplasm StagingOdds RatioPneumonectomyPostoperative ComplicationsPrognosisRetrospective StudiesRisk AssessmentSEER ProgramSex DistributionSurvival AnalysisUnited StatesConceptsChronic obstructive pulmonary diseaseNonanatomic resectionStage I NSCLCSurgical resectionSurgical approachLung cancerNational Cancer Institute's SurveillanceEarly-stage lung cancerPatients 67 yearsPrimary tumor statusObstructive pulmonary diseaseCell lung cancerHospital factorsLung resectionWedge resectionClinical factorsPulmonary diseaseMultivariable analysisTumor sizeLarge tumorsHospital characteristicsTumor statusMedicare patientsResectionPatients
2011
Intrathoracic hemorrhage after placement of a subpleural catheter
Sondergaard K, Boffa DJ, Detterbeck FC, Kim AW. Intrathoracic hemorrhage after placement of a subpleural catheter. JAAPA 2011, 24: 34, 37. PMID: 22111180, DOI: 10.1097/01720610-201111000-00006.Peer-Reviewed Original ResearchImpact of Hospital Volume of Thoracoscopic Lobectomy on Primary Lung Cancer Outcomes
Park HS, Detterbeck FC, Boffa DJ, Kim AW. Impact of Hospital Volume of Thoracoscopic Lobectomy on Primary Lung Cancer Outcomes. The Annals Of Thoracic Surgery 2011, 93: 372-379. PMID: 21945225, DOI: 10.1016/j.athoracsur.2011.06.054.Peer-Reviewed Original ResearchConceptsPrimary lung cancer patientsLung cancer patientsShorter LOSMultivariable analysisMedian LOSHospital volumeIndependent predictorsPulmonary lobectomyOpen lobectomyCancer patientsVAT volumeUtilization Project Nationwide Inpatient Sample databaseVideo-assisted thoracoscopic surgery lobectomyHospital operative volumeShorter median LOSLung cancer outcomesPrimary lung cancerHigher hospital volumeShort-term outcomesThoracoscopic surgery lobectomyDiseases procedure codesTotal complicationsHospital lengthHospital morbidityVATS patientsCorrection of postpneumonectomy syndrome using a custom implant
McRae MC, Detterbeck FC, Narayan D. Correction of postpneumonectomy syndrome using a custom implant. BMJ Case Reports 2011, 2011: bcr1120103523. PMID: 22700614, PMCID: PMC3079506, DOI: 10.1136/bcr.11.2010.3523.Peer-Reviewed Original ResearchMeSH KeywordsAdultFemaleHumansPneumonectomyPostoperative ComplicationsProstheses and ImplantsSyndromeConceptsPostpneumonectomy syndromeLeft main stem bronchusMarked mediastinal shiftFurther postoperative complicationsMain stem bronchusBronchial carcinoid tumorsSymptoms 4 monthsPostoperative complicationsMediastinal shiftRight pneumonectomyCarcinoid tumorsRecurrent infectionsSevere narrowingTumor recurrenceComplete resolutionSaline implantsStandard expanderBreast implantsSuperior implantThree timesPatientsRecurrenceSyndromeImplantsVertebral column