Background Patients who have stoma surgery are at higher risk for readmission following discharge. Some may benefit from closer post-discharge surveillance to detect complications earlier and provide timely treatment to avoid readmission. However, there are a paucity of contemporary tools to identify those at higher risk of readmission following discharge after stoma surgery. Here, we aimed to determine factors associated with readmissions, within 30 days of discharge, following stoma surgery. Method Retrospective review of all patients who underwent a single stoma formation at a single tertiary colorectal service (2019–2021). Results 423 patients underwent 220 ileostomy and 203 colostomy formation surgeries. Overall, 87 (20.6%) patients were readmitted within 30 days of discharge. The rate of readmission in those with IBD (n=87) was 18.4%, cancer (n=208) 20.7%, diverticular disease (n=45) 17.8% and vascular disease (n=19) was 36.8% (p>0.05). There was no association between readmission and gender, aetiology, smoking, weight, or discharge to social care. The only comorbidity associated with increased readmission was chronic heart failure (p=0.05), no other comorbidities were associated with increased readmission. There was an increased incidence of readmission in patients with post-operative stoma-specific complications (bleeding p=0.02; high-output stoma p=0.01) and in patients who received loop ileostomies compared to other stoma types (34.0% versus 18.6%; p=0.01). There was a protective effect in those given nutritional supplements post-operatively (p=0.04). Conclusion Readmission following single stoma formation is related to variables that potentially provide the means to triage, risk score and potentially predict readmission. Further work is being undertaken to develop and prospectively to validate a model.
Background: Eye-tracking has become an increasingly popular research tool within the field of cleft lip and/or palate (CL+/−P). Despite this, there are no standardized protocols for conducting research. Our objective was to conduct a literature review of the methodology and outcomes of previous publications using eye-tracking in CL+/−P. Methods: The PubMed, Google Scholar, and Cochrane databases were searched to identify all articles published up to August 2022. All articles were screened by two independent reviewers. Inclusion criteria included using eye-tracking, image stimuli of CL+/−P, and outcome reporting using areas of interest (AOIs). Exclusion criteria included non-English studies, conference articles, and image stimuli of conditions other than CL+/−P. Results: Forty articles were identified, and 16 met the inclusion/exclusion criteria. Thirteen studies only displayed images of individuals following cleft lip surgery with three only displaying unrepaired cleft lips. Significant variation was found in study design, particularly in the AOIs used to report gaze outcomes. Ten studies asked participants to provide an outcome score alongside eye-tracking; however, only four compared outcome data to eye-tracking data. This review is primarily limited by the minimal number of publications in this area. Conclusions: Eye-tracking can be a powerful tool in evaluating appearance outcomes following CL+/−P surgery. It is currently limited by the lack of standardized research methodology and varied study design. Before future work, a replicable protocol should be developed to maximize the potential of this technology.
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