Factors associated with prolonged length of stay for elective hepatobiliary and neurosurgery patients: a retrospective medical record review

Siu Yin Lee, Soo Hoon Lee, Jenny H.H. Tan, Howard S.L. Foo, Phillip Phan, Alfred W.C. Kow, Sein Lwin, Penelope M.Y. Seah, Siti Zubaidah Mordiffi

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries. Thus, with potentially increased numbers of elective HPB and NS, this study seeks to explore perioperative factors associated with prolonged LOS for these patients to improve safety and quality of practice.

METHODS: A retrospective cross-sectional medical record review study from January 2014 to January 2015 was conducted at a 1250-bed tertiary academic hospital in Singapore. All elective HPB and NS patients over 18 years old were included in the study except day and emergency surgeries, resulting in 150 and 166 patients respectively. Prolonged LOS was defined as above median LOS based on the complexity of the surgical procedure. The predictor variables were preoperative, intraoperative, and postoperative factors. Student's t-test and stepwise logistic regression analyses were conducted to determine which factors were associated with prolonged LOS.

RESULTS: Factors associated with prolonged LOS for the HPB sample were age and admission after 5 pm but for the NS sample, they were functional status, referral to occupational therapy, and the number of hospital-acquired infections.

CONCLUSION: Our findings indicate that preoperative factors had the greatest association with prolonged LOS for HPB and NS elective surgeries even after adjusting for surgical complexity, suggesting that patient safety and quality of care may be improved with better pre-surgery patient preparation and admission practices.

Original languageEnglish (US)
Number of pages1
JournalBMC Health Services Research
Volume18
Issue number1
DOIs
StatePublished - Jan 5 2018

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Neurosurgery
Medical Records
Length of Stay
Cross Infection
Emergencies
Southeastern Asia
Far East
Quality of Health Care
Occupational Therapy
Patient Admission
Singapore
Intracranial Aneurysm
Patient Safety
Ambulatory Surgical Procedures
Tertiary Care Centers
Inpatients
Neoplasms
Referral and Consultation

Keywords

  • Ambulatory services
  • Elective surgery
  • Intraoperative
  • Postoperative care
  • Preoperative
  • Prolonged length of stay

ASJC Scopus subject areas

  • Health Policy

Cite this

Factors associated with prolonged length of stay for elective hepatobiliary and neurosurgery patients : a retrospective medical record review. / Lee, Siu Yin; Lee, Soo Hoon; Tan, Jenny H.H.; Foo, Howard S.L.; Phan, Phillip; Kow, Alfred W.C.; Lwin, Sein; Seah, Penelope M.Y.; Mordiffi, Siti Zubaidah.

In: BMC Health Services Research, Vol. 18, No. 1, 05.01.2018.

Research output: Contribution to journalArticle

Lee, Siu Yin ; Lee, Soo Hoon ; Tan, Jenny H.H. ; Foo, Howard S.L. ; Phan, Phillip ; Kow, Alfred W.C. ; Lwin, Sein ; Seah, Penelope M.Y. ; Mordiffi, Siti Zubaidah. / Factors associated with prolonged length of stay for elective hepatobiliary and neurosurgery patients : a retrospective medical record review. In: BMC Health Services Research. 2018 ; Vol. 18, No. 1.
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abstract = "BACKGROUND: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries. Thus, with potentially increased numbers of elective HPB and NS, this study seeks to explore perioperative factors associated with prolonged LOS for these patients to improve safety and quality of practice.METHODS: A retrospective cross-sectional medical record review study from January 2014 to January 2015 was conducted at a 1250-bed tertiary academic hospital in Singapore. All elective HPB and NS patients over 18 years old were included in the study except day and emergency surgeries, resulting in 150 and 166 patients respectively. Prolonged LOS was defined as above median LOS based on the complexity of the surgical procedure. The predictor variables were preoperative, intraoperative, and postoperative factors. Student's t-test and stepwise logistic regression analyses were conducted to determine which factors were associated with prolonged LOS.RESULTS: Factors associated with prolonged LOS for the HPB sample were age and admission after 5 pm but for the NS sample, they were functional status, referral to occupational therapy, and the number of hospital-acquired infections.CONCLUSION: Our findings indicate that preoperative factors had the greatest association with prolonged LOS for HPB and NS elective surgeries even after adjusting for surgical complexity, suggesting that patient safety and quality of care may be improved with better pre-surgery patient preparation and admission practices.",
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T1 - Factors associated with prolonged length of stay for elective hepatobiliary and neurosurgery patients

T2 - a retrospective medical record review

AU - Lee, Siu Yin

AU - Lee, Soo Hoon

AU - Tan, Jenny H.H.

AU - Foo, Howard S.L.

AU - Phan, Phillip

AU - Kow, Alfred W.C.

AU - Lwin, Sein

AU - Seah, Penelope M.Y.

AU - Mordiffi, Siti Zubaidah

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N2 - BACKGROUND: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries. Thus, with potentially increased numbers of elective HPB and NS, this study seeks to explore perioperative factors associated with prolonged LOS for these patients to improve safety and quality of practice.METHODS: A retrospective cross-sectional medical record review study from January 2014 to January 2015 was conducted at a 1250-bed tertiary academic hospital in Singapore. All elective HPB and NS patients over 18 years old were included in the study except day and emergency surgeries, resulting in 150 and 166 patients respectively. Prolonged LOS was defined as above median LOS based on the complexity of the surgical procedure. The predictor variables were preoperative, intraoperative, and postoperative factors. Student's t-test and stepwise logistic regression analyses were conducted to determine which factors were associated with prolonged LOS.RESULTS: Factors associated with prolonged LOS for the HPB sample were age and admission after 5 pm but for the NS sample, they were functional status, referral to occupational therapy, and the number of hospital-acquired infections.CONCLUSION: Our findings indicate that preoperative factors had the greatest association with prolonged LOS for HPB and NS elective surgeries even after adjusting for surgical complexity, suggesting that patient safety and quality of care may be improved with better pre-surgery patient preparation and admission practices.

AB - BACKGROUND: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries. Thus, with potentially increased numbers of elective HPB and NS, this study seeks to explore perioperative factors associated with prolonged LOS for these patients to improve safety and quality of practice.METHODS: A retrospective cross-sectional medical record review study from January 2014 to January 2015 was conducted at a 1250-bed tertiary academic hospital in Singapore. All elective HPB and NS patients over 18 years old were included in the study except day and emergency surgeries, resulting in 150 and 166 patients respectively. Prolonged LOS was defined as above median LOS based on the complexity of the surgical procedure. The predictor variables were preoperative, intraoperative, and postoperative factors. Student's t-test and stepwise logistic regression analyses were conducted to determine which factors were associated with prolonged LOS.RESULTS: Factors associated with prolonged LOS for the HPB sample were age and admission after 5 pm but for the NS sample, they were functional status, referral to occupational therapy, and the number of hospital-acquired infections.CONCLUSION: Our findings indicate that preoperative factors had the greatest association with prolonged LOS for HPB and NS elective surgeries even after adjusting for surgical complexity, suggesting that patient safety and quality of care may be improved with better pre-surgery patient preparation and admission practices.

KW - Ambulatory services

KW - Elective surgery

KW - Intraoperative

KW - Postoperative care

KW - Preoperative

KW - Prolonged length of stay

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JO - BMC Health Services Research

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