Fatores de risco para prolongamento do tempo de permaněncia após cirurgia colorretal

Translated title of the contribution: Risk factors for prolonged length of stay after colorectal surgery

Luiz Felipe de Campos Lobato, Patrícia Cristina Alves Ferreira, Elizabeth C. Wick, Ravi P. Kiran, Feza H. Remzi, Matthew F. Kalady, Jon D. Vogel

Research output: Contribution to journalArticle

Abstract

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 ACSNSQIP variables as predictive variables. P-value <0.01 was considered signifi cant. 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.

Original languagePortuguese
Pages (from-to)22-27
Number of pages6
JournalJournal of Coloproctology
Volume33
Issue number1
StatePublished - 2013

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Colorectal Surgery
Length of Stay
Administrative Personnel
Sepsis
Surgical Wound Infection
Colectomy
Operative Time
Quality Improvement
Ambulatory Surgical Procedures
Reoperation
Hematocrit
Artificial Respiration
Urinary Tract Infections
Venous Thrombosis
Crohn Disease
Population
Weight Loss
Albumins
Pneumonia
Multivariate Analysis

Keywords

  • Colectomy
  • Length of stay
  • Morbidity

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Lobato, L. F. D. C., Ferreira, P. C. A., Wick, E. C., Kiran, R. P., Remzi, F. H., Kalady, M. F., & Vogel, J. D. (2013). Fatores de risco para prolongamento do tempo de permaněncia após cirurgia colorretal. Journal of Coloproctology, 33(1), 22-27.

Fatores de risco para prolongamento do tempo de permaněncia após cirurgia colorretal. / Lobato, Luiz Felipe de Campos; Ferreira, Patrícia Cristina Alves; Wick, Elizabeth C.; Kiran, Ravi P.; Remzi, Feza H.; Kalady, Matthew F.; Vogel, Jon D.

In: Journal of Coloproctology, Vol. 33, No. 1, 2013, p. 22-27.

Research output: Contribution to journalArticle

Lobato, LFDC, Ferreira, PCA, Wick, EC, Kiran, RP, Remzi, FH, Kalady, MF & Vogel, JD 2013, 'Fatores de risco para prolongamento do tempo de permaněncia após cirurgia colorretal', Journal of Coloproctology, vol. 33, no. 1, pp. 22-27.
Lobato LFDC, Ferreira PCA, Wick EC, Kiran RP, Remzi FH, Kalady MF et al. Fatores de risco para prolongamento do tempo de permaněncia após cirurgia colorretal. Journal of Coloproctology. 2013;33(1):22-27.
Lobato, Luiz Felipe de Campos ; Ferreira, Patrícia Cristina Alves ; Wick, Elizabeth C. ; Kiran, Ravi P. ; Remzi, Feza H. ; Kalady, Matthew F. ; Vogel, Jon D. / Fatores de risco para prolongamento do tempo de permaněncia após cirurgia colorretal. In: Journal of Coloproctology. 2013 ; Vol. 33, No. 1. pp. 22-27.
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AU - Kiran, Ravi P.

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AU - Kalady, Matthew F.

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N2 - 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 ACSNSQIP variables as predictive variables. P-value <0.01 was considered signifi cant. 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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