Stephen C. Yang

Standardized clinical care pathways for major thoracic cases reduce hospital costs

BACKGROUND Standardized clinical care pathways have been developed for postoperative management in an attempt to contain costs in an era of rising health care costs and limited resources. The purpose of this study was to assess the effect of these pathways on length of stay, hospital charges, and outcome for major thoracic surgical procedures. METHODS All anatomic lung (segmentectomy, lobectomy, and pneumonectomy) and partial and complete esophageal resections performed from July 1991 to July 1997 were retrospectively analyzed for length of stay, hospital charges, and outcome. A prospectively developed database was used. Clinical care pathways were introduced in March 1994. Comparisons were made between the procedures performed before (group I) and after (group II) pathway implementation. Common to both pathways are early mobilization and prudent x-ray and laboratory analysis. In addition, the pathway for esophagectomies emphasizes overnight intubation with 24-hour intensive care unit care, and staged diet advancement. The discharge goal was postoperative day 10. For lung resection the emphasis is early postoperative extubation with overnight intensive care unit management. The discharge goal was postoperative day 7. RESULTS Group I esophagectomies (n = 56) had significantly greater hospital charges compared with group II (n = 96) (

Promoter Hypermethylation of Resected Bronchial Margins: A Field Defect of Changes?

21,977 +/-

Phase II Evaluation of Preoperative Chemoradiation and Postoperative Adjuvant Chemotherapy for Squamous Cell and Adenocarcinoma of the Esophagus

13,555 versus

Trial of a novel synthetic sealant in preventing air leaks after lung resection

17,919 +/-

Inactivation of the INK4A/ARF locus frequently coexists with TP53 mutations in non-small cell lung cancer

5,321; p < 0.04, in actual dollars) and (

Pulmonary resection in octogenarians with stage I nonsmall cell lung cancer: a 22-year experience.

29,097 +/-

Hypermethylation of the GATA Genes in Lung Cancer

18,586 versus

Delayed diagnosis and elevated mortality in an urban population with HIV and lung cancer: implications for patient care.

19,260 +/-

Patterns of PD-L1 expression and CD8 T cell infiltration in gastric adenocarcinomas and associated immune stroma

6,000; p < 0.001, in dollars adjusted for inflation) and greater length of stay (13.6 +/- 6.9 versus 9.5 +/- 2.8 days; p < 0.001). Group I lung resections (n = 185) had a significantly greater length of stay compared with group II (n = 241) (8.0 +/- 6.2 versus 6.4 +/- 3.8 days; p < 0.002); although charges trended downward (

Recurrence after neoadjuvant chemoradiation and surgery for esophageal cancer: Does the pattern of recurrence differ for patients with complete response and those with partial or no response?

13,113 +/-