Predicting Inpatient Stay Lasting 2 Midnights or Longer After Robotic Surgery for Endometrial Cancer

Liang, Margaret; Rosen, Melvin; Rath, Kellie S.; Hade, Erinn M.; Clements, Aine; Backes, Floor J.; Eisenhauer, Eric L.; Salani, Ritu; O’Malley, David M.; Fowler, Jeffrey M.; Cohn, David E.

doi:10.1016/j.jmig.2014.12.167

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…Several studies that were retrieved in the initial search were excluded owing to same-day discharge being defined as discharge within 24 hours of surgery; this definition made it impossible to differentiate between patients who were discharged either before or after midnight. [34][35][36][37] In determining the risk of bias, two authors (M.K. and M.M.J.…”

Section: Resultsmentioning

confidence: 99%

“…In six studies, it was prospectively planned that patients would undergo same‐day discharge whereas there were nine studies where patients were retrospectively categorized as having undergone same‐day discharge or having been hospitalized, depending on the length of stay recorded on patient charts. Several studies that were retrieved in the initial search were excluded owing to same‐day discharge being defined as discharge within 24 hours of surgery; this definition made it impossible to differentiate between patients who were discharged either before or after midnight …”

Section: Resultsmentioning

confidence: 99%

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Systematic review of same‐day discharge after minimally invasive hysterectomy

Korsholm

Mogensen

Jeppesen

et al. 2016

Intl J Gynecology & Obste

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Background: Same-day discharge has been suggested to safe and acceptable following minimally invasive hysterectomy. Objectives:To evaluate the feasibility of same-day discharge following minimally invasive hysterectomy and to identify associated factors. Search strategy: Medline, Embase and the Cochrane Central Register of ControlledTrials were systematically searched using the terms "same day discharge", "minimally invasive surgery", and "hysterectomy" between October 1 and October 31, 2015. No language or publication date restrictions were included.Selection criteria: Randomized controlled trials and observational studies evaluating same-day discharge before midnight on the day of minimally invasive hysterectomy were included.Data collection and analysis: Study characteristics, pre-operative selection criteria, and predictive factors for same-day discharge were analyzed.Main results: There were 15 observational studies with 11 992 patients included.Significant heterogeneity was observed in the studies, and publication and selection bias could have potentially affected the results. All the studies concluded that sameday discharge was feasible. However, some factors were associated with a decreased possibility of same-day discharge; these were older age, beginning surgery later than 1:00 pm and completing surgery later than 6:00 pm, longer duration of operation, and high estimated blood loss.Conclusions: Same-day discharge appears feasible for a majority of patients who undergo minimally invasive hysterectomies if adequate emphasis is placed on presurgical planning and careful patient selection.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Systematic review of same‐day discharge after minimally invasive hysterectomy

Korsholm

Mogensen

Jeppesen

et al. 2016

Intl J Gynecology & Obste

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“…3 Identification of high-and lowrisk patients may facilitate appropriate redirection of preventative resources. [9][10][11] In our current study, we sought to identify some of these risk factors. It is our belief that high-and low-risk patients may be able to be identified perioperatively, thus, allowing for improved risk stratification of patients.…”

mentioning

confidence: 99%

Factors Associated with a Short (<2 Days) or Long (>10 Days) Length of Stay after Colectomy: A Multivariate Analysis of over 400 Patients

Cologne

Byers

Rosen

et al. 2016

The American Surgeon

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A prospectively maintained database of 415 patients undergoing colectomy was evaluated. We performed a logistic regression analysis to identify factors associated with 1) length of stay (LOS) of 2 days or less and 2) LOS of 10 days or more. Investigated variables included demographics, American Society of Anesthesiology (ASA) score, diagnosis, operative procedure, approach and time, transfusion requirements, and occurrence of any complications. Factors associated with a LOS of two days or less included ASA [odds ratio (OR): 0.34, 95% confidence interval (CI): 0.208–0.576], use of transversus abdominis plane block (OR: 5.259, 95% CI: 2.825–9.791), and operative time (OR: 0.98, 95% CI: 0.974–0.986). Age >65 had an OR of 1.73, though this did not reach statistical significance. Factors associated with LOS >10 days included ASA (OR: 2.152, 95% CI: 1.245–3.721), anastomotic leak (OR: 2.163, 95% CI: 1.486–3.148), ileus (OR: 8.790, 95% CI: 4.501–17.165), and surgical site infection (OR: 5.846, 95% CI: 2.764–12.362). Cancer and transfusion status were associated but did not reach statistical significance. Although operative time was longer in left-sided resections, no differences in LOS were observed. In conclusion, numerous factors are associated with short or long LOS and may help stratify resource utilization after colectomy. Further study is needed to confirm our findings.

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