Evaluating unplanned readmission and prolonged length of stay following minimally invasive surgery for endometrial cancer

Kohut, Andrew; Earnhardt, Mary Cathryn; Cuccolo, Nicholas G.; Kim, Chi-Son; Song, Mi‐Yeon; Girda, Eugenia; Meritens, Alexandre Buckley de; Stephenson, Randolph; Balica, Adrian; Leiser, Aliza; Demissie, Kitaw; Rodrı́guez-Rodrı́guez, Lorna

doi:10.1016/j.ygyno.2019.08.023

Cited by 9 publications

(16 citation statements)

References 39 publications

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“…This study found that longer operative time, undergoing major surgery, and general anesthesia were independently associated with extended LOS. These findings were consistent with previous studies that report association between long operative time and prolonged LOS 13,23–25 . However, prior studies have shown mixed results regarding the association of major surgical procedures.…”

Section: Discussionsupporting

confidence: 92%

“…This pattern was consistent in sub‐analysis by major and minor surgery. The rate of prolonged LOS found in our study is consistent with prior literature, in which 4.8%–9.7% of patients experience prolonged LOS of ≥2 nights following gynecologic and urologic procedures 10,13,23 . While an overnight stay following outpatient FPRS is common practice in the United States for higher risk patients, this incidence of prolonged LOS highlights the opportunity for improvement of postoperative patient experience and outcomes when clinically safe and feasible.…”

Section: Discussionsupporting

confidence: 89%

“…While age may be associated with more comorbid conditions, frailty, defined by a composite of medical comorbidities, was also found to independently correlate with prolonged LOS. Prior studies have shown similar associations between baseline comorbidities and LOS 13,23–25 . While patient age is a fixed condition, frailty and comorbid conditions may be modified to maximize patient health status before outpatient FPRS.…”

Section: Discussionmentioning

confidence: 86%

“…The rate of prolonged LOS found in our study is consistent with prior literature, in which 4.8%-9.7% of patients experience prolonged LOS of ≥2 nights following gynecologic and urologic procedures. 10,13,23 While an overnight stay following outpatient FPRS is common practice in the United States for higher risk patients, this incidence of prolonged LOS highlights the opportunity for improvement of postoperative patient experience and outcomes when clinically safe and feasible. Factors examined in this study may not necessarily be causative of prolonged LOS but addressing these associations can facilitate better patient selection and surgical optimization.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of prolonged admission after outpatient female pelvic reconstructive surgery

Simi

Chapman

Zillioux

et al. 2022

Neurourology and Urodynamics

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This study aimed to determine factors associated with prolonged hospital admission following outpatient female pelvic reconstructive surgery (FPRS) and associated adverse clinical outcomes.Methods: Using the National Surgical Quality Improvement Program database, we identified outpatient FPRS performed 2011-2016. Isolated hysterectomy without concurrent prolapse repair was excluded. Surgeries were classified as major or minor for analysis. The primary outcome was prolonged length of stay (LOS), defined as admission of ≥2 days. Secondary outcomes included complications, readmission and reoperation associated with prolonged LOS. We abstracted data on covariates, and following univariable analysis, performed backward stepwise regression analysis.Results: A total of 29645 women were included: 12311 (41.5%) major and 17334 (58.5%) minor procedures. A total of 6.9% (2033) had a prolonged LOS.On full cohort multivariable regression analysis, patient characteristics associated with prolonged LOS were older age (odds ratio [OR]: 1.1 per 10 years, confidence interval [CI]: 1.06-1.1, p < 0.001), frailty (OR: 1.8, 95% CI:1.3-2.6, p = 0.001), and Caucasian race (OR: 1.2, CI: 1.02-1.3, p = 0.024). Associated surgical factors included having a major surgical procedure (OR:1.3, CI: 1.2-1.4, p < 0.001), use of general anesthesia (OR: 2.0, CI: 1.5-2.6, p < 0.001) and longer operative time (OR: 2.0, CI: 1.8-2.2, p < 0.001). The occurrence of any complication (10.3% vs. 4.7%, p < 0.001), hospital readmission (4.3% vs. 1.7%, p < 0.001), and reoperation (2.7% vs. 1.0%, p < 0.001) were more likely with prolonged LOS.Conclusions: After outpatient FPRS, 6.9% of patients experience an admission of ≥2 days. Prolonged LOS is more common in patients who are older, frail and Caucasian, and in those who have major surgery with long operative time and general anesthesia.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of prolonged admission after outpatient female pelvic reconstructive surgery

Simi

Chapman

Zillioux

et al. 2022

Neurourology and Urodynamics

View full text Add to dashboard Cite

show abstract

“…While this aspect is promising and not wholly unexpected, it is multifactorial and isn't easy to fully understand based solely on the data provided in this analysis. The literature has already widely described that patients with more comorbidities, metastatic cancer, or receiving open surgery often require a more extended stay in the hospital (16,17). These aspects directly impact the clinical recovery of such patients as longer perioperative treatments, multidisciplinary procedures or exams, and additional care is needed.…”

Section: Discussionmentioning

confidence: 99%

Permanent Stoma: A Quality Outcome in Treatment of Rectal Cancer and Its Impact on Length of Stay

Lemini

Jabbal

Stanek

et al. 2021

Preprint

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Background This study aimed to identify socioeconomic predictors of permanent stoma in rectal cancer treatment and examine its association with length of stay at the treatment facility.MethodsRectal cancer patients were identified from the Agency for Health Care Administration Florida Hospital Inpatient Discharge Dataset. Multivariate regression models were utilized to identify demographic, and socioeconomic factors associated with receiving a permanent stoma as well as the associated length of stay of these patients.ResultsOf 2,630 rectal cancer patients who underwent surgery for rectal cancer, 21% had a permanent stoma. The odds of receiving permanent stoma increased with higher Elixhauser score, metastatic disease, residing in Southwest Florida, and having Medicaid insurance or no insurance/self-payers (p<0.05). Patients with a permanent stoma had a significantly extended stay after surgery (p<0.001). ConclusionsPatients with a permanent stoma following cancer resection were more likely to have open surgery, had more comorbidities, and had a longer length of stay. Additionally, the payer type significantly affected the length of stay and odds of receiving a permanent stoma.

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Feasibility of combining pelvic reconstruction with gynecologic oncology-related surgery

et al. 2022

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Evaluating unplanned readmission and prolonged length of stay following minimally invasive surgery for endometrial cancer

Cited by 9 publications

References 39 publications

Predictors of prolonged admission after outpatient female pelvic reconstructive surgery

Predictors of prolonged admission after outpatient female pelvic reconstructive surgery

Permanent Stoma: A Quality Outcome in Treatment of Rectal Cancer and Its Impact on Length of Stay

Feasibility of combining pelvic reconstruction with gynecologic oncology-related surgery

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