P394 Preoperative factors associated with prolonged postoperative in-hospital length of stay in patients with Crohn’s disease undergoing intestinal resection or strictureplasty

Abstract

Background Postoperative complications might not be accurately registered, leading to weakness in registry data studies. Aim To investigate factors that influence postoperative in-hospital length of stay (LOS) in patients with Crohn’s disease (CD) undergoing bowel surgery. Furthermore, the study aimed to evaluate LOS as a surrogate for postoperative outcome. Methods A multicentre retrospective cohort study. Inclusion criteria were adult patients with CD who underwent bowel surgery with either anastomosis or stricturoplasty. All timings of surgeries are regardless of the method of access to the abdominal cavities. Patients with stoma were excluded. Demographic data, preoperative medications, previous operations for CD, preoperative sepsis, and operation was recorded. The primary outcome was LOS while the secondary outcome variable was postoperative complications. Results 449 patients who underwent abdominal surgery for CD were included. 265/449 (59%) were female. Median age was 37 years (IQR =20), median LOS was seven days (IQR =6). Patients with longer LOS had higher rates of re-laparotomy/re-laparoscopy (45/228 (19.7%) vs. 9/219 (4.1%) p = 0.01). In multivariate analysis, age (OR = 1.024 [CI 95% 1.007–1.041], p = 0.005), preoperative intra-abdominal abscess (OR =0.39 [CI 95% 0.185–0.821], p = 0.013), and previous laparotomy/laparoscopy (Or = 0.57 [CI 95% 0.334–0.918], p = 0.021) were associated with prolonged LOS. LOS correlated with postoperative complications after adjustment for age, gender, previous laparotomy/laparoscopy, and preoperative intra-abdominal abscesses (OR = 1.28 [CI 95% 1.199–1.366], p < 0.0001). Conclusion Age, preoperative intra-abdominal abscess, and previous laparotomy/laparoscopy significantly prolonged LOS. LOS correlated with postoperative complications and can, therefore, act as a surrogate for the postoperative outcome.