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

Interact Cardiovasc Thorac Surg. 2011 Nov;13(5):490-3; discussion 493. doi: 10.1510/icvts.2011.280941. Epub 2011 Aug 18.

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.

MeSH terms

  • Aged
  • Case-Control Studies
  • Chest Tubes* / economics
  • Chi-Square Distribution
  • Clinical Competence
  • Cost Savings
  • Electrical Equipment and Supplies
  • Equipment Design
  • Hospital Costs
  • Humans
  • Intubation, Intratracheal / economics
  • Intubation, Intratracheal / instrumentation*
  • Italy
  • Learning Curve*
  • Length of Stay
  • Middle Aged
  • Pneumonectomy / adverse effects*
  • Pneumonectomy / economics
  • Propensity Score
  • Suction / economics
  • Suction / instrumentation*
  • Time Factors