title: Impact of the learning curve in the use of a novel electronic chest drainage system after pulmonary lobectomy: a case-matched analysis on the duration of chest tube usage.
abstract: The objective of this investigation was to verify the impact of the learning curve involved after the introduction of a novel electronic chest drainage device on the duration of chest tube usage following pulmonary lobectomy. Propensity score case-matched analysis was used to compare the first consecutive 51 lobectomy patients managed with an electronic chest drainage (E) device with 51 controls managed with a traditional device (T). There was no difference in the characteristics of the two matched groups. Compared with patients managed with a traditional device, those with the electronic one had 1.9-day shorter duration of chest tube drainage (2.5 vs. 4.4 days; P<0.0001) and a 1.5-day shorter hospital stay (4.5 vs. 6 days; P=0.0003). Consequently, they had an average reduction in hospital costs of €751 (€1802 vs. €2553; P=0.0002). Compared with those in group T, patients in group E had a consistently shorter duration of chest tube use in relation to the very first patients treated. The learning curve sloped down for the first 40 patients before reaching a plateau, when the maximum benefit of using the electronic device was evident. Compared with traditional devices, the use of a novel electronic chest drainage system was beneficial from its initial application. The inherent learning curve was short and did not affect the efficiency of the system.
authors.affiliation: Division of Thoracic Surgery, Riuniti Hospitals Ancona, Ancona, Italy. ceciliapompili@gmail.com
authors.forename: Cecilia
authors.initials: C
authors.lastname: Pompili
authors.forename: Alessandro
authors.initials: A
authors.lastname: Brunelli
authors.forename: Michele
authors.initials: M
authors.lastname: Salati
authors.forename: Majed
authors.initials: M
authors.lastname: Refai
authors.forename: Armando
authors.initials: A
authors.lastname: Sabbatini
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015505:Chest Tubes / Q000191:economics; D016009:Chi-Square Distribution; D002983:Clinical Competence; D017046:Cost Savings; D055615:Electrical Equipment and Supplies; D004867:Equipment Design; D017721:Hospital Costs; D006801:Humans; D007442:Intubation, Intratracheal / Q000191:economics / Q000295:instrumentation*; D007558:Italy; D059032:Learning Curve; D007902:Length of Stay; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects* / Q000191:economics; D057216:Propensity Score; D013396:Suction / Q000191:economics / Q000295:instrumentation*; D013997:Time Factors