Risk factors for prolonged length of stay after colorectal surgery
OBJECTIVE: Colorectal surgeons often struggle to explain to administrators/payers reasons for prolonged length of stay (LOS). This study aim was to identify factors associated with increased LOS after colorectal surgery. DESIGN: The study population included patients from the 2007 American-College-of-Surgeons-National-Surgical-Quality-Improvement-Program (ACS-NSQIP) database undergoing ileocolic resection, segmental colectomy, or anterior resection. The study population was divided into normal (below 75th percentile) and prolonged LOS (above the 75th percentile). A multivariate analysis was performed using prolonged LOS as dependent variable and ACS-NSQIP variables as predictive variables. P-value < 0.01 was considered significant. RESULTS: 12,269 patients with a median LOS of 6 (inter-quartile range 4-9) days were included. There were 2,617 (21.3%) patients with prolonged LOS (median 15 days, inter-quartile range 13-22). 1,308 (50%) were female, and the median age was 69 (inter-quartile range 57-79) years. Risk factors for prolonged LOS were male gender, congestive heart failure, weight loss, Crohn's disease, preoperative albumin < 3.5 g/dL and hematocrit < 47%, baseline sepsis, ASA class ≥ 3, open surgery, surgical time ≥ 190 min, postoperative pneumonia, failure to wean from mechanical ventilation, deep venous thrombosis, urinary-tract infection, systemic sepsis, surgical site infection and reoperation within 30-days from the primary surgery. CONCLUSION: Multiple factors are associated with increased LOS after colorectal surgery. Our results are useful for surgeons to explain prolonged LOS to administrators/payers who are critical of this metric.
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Sociedade Brasileira de Coloproctologia
2013
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oai:scielo:S2237-936320130001000222015-07-24Risk factors for prolonged length of stay after colorectal surgeryLobato,Luiz Felipe de CamposFerreira,Patrícia Cristina AlvesWick,Elizabeth C.Kiran,Ravi P.Remzi,Feza H.Kalady,Matthew F.Vogel,Jon D. Colectomy Morbidity Length of stay OBJECTIVE: Colorectal surgeons often struggle to explain to administrators/payers reasons for prolonged length of stay (LOS). This study aim was to identify factors associated with increased LOS after colorectal surgery. DESIGN: The study population included patients from the 2007 American-College-of-Surgeons-National-Surgical-Quality-Improvement-Program (ACS-NSQIP) database undergoing ileocolic resection, segmental colectomy, or anterior resection. The study population was divided into normal (below 75th percentile) and prolonged LOS (above the 75th percentile). A multivariate analysis was performed using prolonged LOS as dependent variable and ACS-NSQIP variables as predictive variables. P-value < 0.01 was considered significant. RESULTS: 12,269 patients with a median LOS of 6 (inter-quartile range 4-9) days were included. There were 2,617 (21.3%) patients with prolonged LOS (median 15 days, inter-quartile range 13-22). 1,308 (50%) were female, and the median age was 69 (inter-quartile range 57-79) years. Risk factors for prolonged LOS were male gender, congestive heart failure, weight loss, Crohn's disease, preoperative albumin < 3.5 g/dL and hematocrit < 47%, baseline sepsis, ASA class ≥ 3, open surgery, surgical time ≥ 190 min, postoperative pneumonia, failure to wean from mechanical ventilation, deep venous thrombosis, urinary-tract infection, systemic sepsis, surgical site infection and reoperation within 30-days from the primary surgery. CONCLUSION: Multiple factors are associated with increased LOS after colorectal surgery. Our results are useful for surgeons to explain prolonged LOS to administrators/payers who are critical of this metric. info:eu-repo/semantics/openAccessSociedade Brasileira de ColoproctologiaJournal of Coloproctology (Rio de Janeiro) v.33 n.1 20132013-04-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632013000100022en10.1590/S2237-93632013000100005 |
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Lobato,Luiz Felipe de Campos Ferreira,Patrícia Cristina Alves Wick,Elizabeth C. Kiran,Ravi P. Remzi,Feza H. Kalady,Matthew F. Vogel,Jon D. |
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Lobato,Luiz Felipe de Campos Ferreira,Patrícia Cristina Alves Wick,Elizabeth C. Kiran,Ravi P. Remzi,Feza H. Kalady,Matthew F. Vogel,Jon D. Risk factors for prolonged length of stay after colorectal surgery |
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Lobato,Luiz Felipe de Campos Ferreira,Patrícia Cristina Alves Wick,Elizabeth C. Kiran,Ravi P. Remzi,Feza H. Kalady,Matthew F. Vogel,Jon D. |
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Lobato,Luiz Felipe de Campos |
title |
Risk factors for prolonged length of stay after colorectal surgery |
title_short |
Risk factors for prolonged length of stay after colorectal surgery |
title_full |
Risk factors for prolonged length of stay after colorectal surgery |
title_fullStr |
Risk factors for prolonged length of stay after colorectal surgery |
title_full_unstemmed |
Risk factors for prolonged length of stay after colorectal surgery |
title_sort |
risk factors for prolonged length of stay after colorectal surgery |
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OBJECTIVE: Colorectal surgeons often struggle to explain to administrators/payers reasons for prolonged length of stay (LOS). This study aim was to identify factors associated with increased LOS after colorectal surgery. DESIGN: The study population included patients from the 2007 American-College-of-Surgeons-National-Surgical-Quality-Improvement-Program (ACS-NSQIP) database undergoing ileocolic resection, segmental colectomy, or anterior resection. The study population was divided into normal (below 75th percentile) and prolonged LOS (above the 75th percentile). A multivariate analysis was performed using prolonged LOS as dependent variable and ACS-NSQIP variables as predictive variables. P-value < 0.01 was considered significant. RESULTS: 12,269 patients with a median LOS of 6 (inter-quartile range 4-9) days were included. There were 2,617 (21.3%) patients with prolonged LOS (median 15 days, inter-quartile range 13-22). 1,308 (50%) were female, and the median age was 69 (inter-quartile range 57-79) years. Risk factors for prolonged LOS were male gender, congestive heart failure, weight loss, Crohn's disease, preoperative albumin < 3.5 g/dL and hematocrit < 47%, baseline sepsis, ASA class ≥ 3, open surgery, surgical time ≥ 190 min, postoperative pneumonia, failure to wean from mechanical ventilation, deep venous thrombosis, urinary-tract infection, systemic sepsis, surgical site infection and reoperation within 30-days from the primary surgery. CONCLUSION: Multiple factors are associated with increased LOS after colorectal surgery. Our results are useful for surgeons to explain prolonged LOS to administrators/payers who are critical of this metric. |
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Sociedade Brasileira de Coloproctologia |
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2013 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632013000100022 |
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