title: Clinical pathway after lung transplantation shortens hospital length of stay without affecting outcome.
abstract: Transplant programs are under pressure to resolve multiple challenges related to quality, cost, and access in a resource-driven customer-focused health care environment. We reviewed outcomes of patients undergoing isolated lung transplantation using a single postoperative clinical pathway, developed between the specialties of Thoracic Surgery, Pulmonary and Critical Care Medicine, and Nursing. The data were retrospectively reviewed for mortality, length to extubation (LE), hospital length of stay (LOS), and readmissions of 183 consecutive patients. One hundred ten women and 73 men with a mean age of 48 +/- 12 years underwent 90 bilateral, 88 single, and 6 repeat lung transplantations. Median LE was 17 hours, and the LOS was 7 days. The operative mortality was 6.5%. One- and 3-year survivals were 82% and 73%, respectively. We conclude that a single multidisciplinary clinical pathway can facilitate early discharge from the hospital. Early hospital discharge after lung transplantation does not compromise early or late outcome.
authors.affiliation: Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, Illinois, USA. wvignesw@surgery.bsd.uchicago.edu
authors.forename: Wickii T
authors.initials: WT
authors.lastname: Vigneswaran
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Bhorade
authors.forename: Mary
authors.initials: M
authors.lastname: Wolfe
authors.forename: Karen
authors.initials: K
authors.lastname: Pelletiere
authors.forename: Edward R
authors.initials: ER
authors.lastname: Garrity
mesh_terms: D000328:Adult; D015331:Cohort Studies; D019091:Critical Pathways; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome