CHEST Guidelines-Thirty-Day-Readmissions-in-Adults-Hospitalized-for (2)

Thirty-Day-Readmissions-in-Adults-Hospitalized-for (2)

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The document discusses the learning curve associated with robotic-assisted thoracic surgery (RobATS) and its adoption patterns from 2004 to 2011. It is noted that achieving proficiency in RobATS, in terms of operative times, mortality, and surgeon comfort, typically requires completing approximately 18±3 consecutive cases. This has been supported by research from Veronesi et al. However, the study highlights the challenges in determining the qualitative and quantitative impacts of varying case numbers, suggesting that 15 cases per year could equate to more than 20 consecutive operations over time. This underscores the difficulty in comprehensively understanding the learning curve due to limited studies.<br /><br />The article also addresses the expansion of RobATS, attributing its growth mainly to new centers adopting the technology, as opposed to established centers increasing their volume. While acknowledging the potential distortion in outcomes due to low-volume centers, the authors advocate for their inclusion in outcome studies, as these centers represent a significant segment of the RobATS landscape.<br /><br />Additionally, the document comprises a correspondence about the findings related to 30-day readmissions for chronic obstructive pulmonary disease (COPD) and bronchiectasis using the Nationwide Readmissions Database for 2013. The correspondence highlights key demographic and comorbidity predictors of readmissions, including age, sex, heart failure, substance abuse, and insurance type. The data reveal that respiratory diseases accounted for a significant portion of readmissions, with a substantial percentage related to COPD or bronchiectasis. The authors suggest that reducing readmissions for COPD requires beyond standard clinical care, indicating a need for multifaceted approaches.<br /><br />These discussions reflect ongoing efforts to optimize surgical practices and patient management in COPD, enhancing understanding and approaches to improving healthcare outcomes.

Keywords

Robotic-assisted thoracic surgery

Learning curve

Proficiency

Adoption patterns

Outcome studies

Low-volume centers

30-day readmissions

Chronic obstructive pulmonary disease

Bronchiectasis

Nationwide Readmissions Database