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 language | Portuguese |
|---|---|
| Pages (from-to) | 22-27 |
| Number of pages | 6 |
| Journal | Journal of Coloproctology |
| Volume | 33 |
| Issue number | 1 |
| State | Published - 2013 |
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Keywords
- Colectomy
- Length of stay
- Morbidity
ASJC Scopus subject areas
- Gastroenterology
Cite this
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 journal › Article
}
TY - JOUR
T1 - Fatores de risco para prolongamento do tempo de permaněncia após cirurgia colorretal
AU - Lobato, Luiz Felipe de Campos
AU - Ferreira, Patrícia Cristina Alves
AU - Wick, Elizabeth C.
AU - Kiran, Ravi P.
AU - Remzi, Feza H.
AU - Kalady, Matthew F.
AU - Vogel, Jon D.
PY - 2013
Y1 - 2013
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.
AB - 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.
KW - Colectomy
KW - Length of stay
KW - Morbidity
UR - http://www.scopus.com/inward/record.url?scp=84880267798&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880267798&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:84880267798
VL - 33
SP - 22
EP - 27
JO - Journal of Coloproctology
JF - Journal of Coloproctology
SN - 2237-9363
IS - 1
ER -