TABLE 2.
Treatment and outcomes by receipt of guideline-concordant versus guideline-discordant care
| Total (n = 13,462) | Guideline-discordant (n = 3996) | Guideline-concordant (n = 9466) | P value | |
|---|---|---|---|---|
| Facility characteristics | ||||
| Median distance to facility, miles, (IQR) | 11.2 (4.8,27.6) | 12.5 (4.9, 32.2) | 10.8 (4.8, 25.6) | <.001 |
| Facility type | .13 | |||
| Community program | 1034 (8.7%) | 286 (8.0%) | 748 (9.0%) | |
| Comprehensive community program | 6112 (51.2%) | 1834 (51.0%) | 4278 (51.3%) | |
| Research/academic program | 4785 (40.1%) | 1474 (41.0%) | 3311 (39.7%) | |
| Treatment characteristics | ||||
| Extent of resection | .642 | |||
| Lobectomy | 11,589 (86.1%) | 3431 (85.9%) | 8158 (86.2%) | |
| Pneumonectomy | 1873 (13.9%) | 565 (14.1%) | 1308 (13.8%) | |
| Median days to definitive surgery (IQR) | 32 (15,51) | 34 (14,55) | 31 (15,50) | <.001 |
| Adjuvant XRT | 2068 (15.4%) | 179 (4.5%) | 1889 (20.0%) | <.001 |
| Adjuvant chemotherapy | 9466 (70.3%) | 0 (0%) | 9466 (100.0%) | <.001 |
| Surgical endpoints | ||||
| Pathologic T stage | .019 | |||
| T1 | 4154 (30.9%) | 1227 (30.7%) | 2927 (30.9%) | |
| T2 | 7373 (54.8%) | 2249 (56.3%) | 5124 (54.1%) | |
| T3 | 1586 (11.8%) | 430 (10.8%) | 1156 (12.2%) | |
| T4 | 349 (2.6%) | 90 (2.3%) | 259 (2.7%) | |
| Pathologic N stage | <.001 | |||
| N1 | 10,113 (75.1%) | 3269 (81.8%) | 6844 (72.3%) | |
| N2 | 3349 (24.9%) | 727 (18.2%) | 2622 (27.7%) | |
| Median number lymph nodes examined, n (IQR) | 11 (7, 18) | 11 (7,17) | 11 (7, 18) | .004 |
| 30-d unplanned readmission | 563 (4.3%) | 225 (5.7%) | 338 (3.6%) | <.001 |
| Median hospital LOS, d, (IQR) | 6 (4, 8) | 6 (4, 9) | 5 (4, 7) | <.001 |
IQR, Interquartile range; XRT, radiation therapy; LOS, length of stay.