70 | wetenschapsdag 2023 Sessie 2c: Laat Me, opereren! x2 Auteurs D.W. van Oyen, R. van den Berg, G.M.H. Marres, E.M. von Meyenfeldt, W.H. Schreurs, H.J. Bonjer Abstract titel Practice variation in perioperative care for patients undergoing anatomical lung resection for non-small cell lung cancer – preliminary results Background Practice variation in perioperative care for lung resection patients, in absence of a national guideline, is thought to be responsible for variation in clinical outcomes. Publication of the Enhanced Recovery After Surgery (ERAS) Society/European Society of Thoracic Surgeons (ESTS) guidelines for lung surgery in 2019 provided an evidence-based set of recommendations concerning elements of perioperative care for lung resection patients. This study aims to gain insight into practice variation regarding these elements in Dutch surgical centres in 2018, the year prior to guideline publication, and to demonstrate the effect of practice variation on clinical outcomes. Methods Descriptive statistics from 8 centres were used to determine practice variation and outcome measures (Length Of Stay (LOS) and 90-day mortality) in this preliminary analysis. For every centre, the percentage of patients already treated according to the ERAS/ESTS guidelines (compliance rate) was determined per perioperative care element. Missing values were interpreted as not complied. Results N=385 patients were included in this preliminary analysis. As expected, some ERAS/ESTS recommendations were already applied, varying between centres (Figure 1). Recommendations ‘carbohydrate drink’ and ‘peroperative normothermia’ had the lowest compliance rate (22% and 32,2%), ‘no preoperative sedation’ and ‘antibiotic prophylaxis’ had the highest compliance rate (96,6% and 96,5%). Most variation between centres was seen for ‘carbohydrate drink’ (1,5% to 100%). In 2018, LOS ranged from 3 to 8 days (Figure 1). The 90-day mortality ranged from 0% to 7,7%.
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