Trends in utilization of laparoscopic colectomy according to race: an analysis of the NIS database

DeAngelis, Erik J.; Zebley, James A; Ileka, Ikechukwu S; Ganguli, Sangrag; Panahi, Armon; Amdur, Richard L.; Vaziri, Khashayar; Lee, Juliet; Jackson, Hope T.

doi:10.1007/s00464-022-09381-w

Cited by 8 publications

(2 citation statements)

References 35 publications

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“…The study group was further narrowed by identifying only IBD patients who underwent small bowel resection, colectomy or proctectomy on the given admission. The diagnosis and procedure codes utilized were drawn from previous similar studies [15–17]. Appendix S1 details the ICD‐10‐CM codes utilized to identify the study cohort.…”

Section: Methodsmentioning

confidence: 99%

Frailty in inflammatory bowel disease: analysis of the National Inpatient Sample 2015–2019

Sharma,

McKechnie,

Heimann

et al. 2024

Colorectal Disease

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AimPreoperative frailty has been associated with adverse postoperative outcomes in various populations, but of its use in patients with inflammatory bowel disease (IBD) remains sparse. The present study aimed to characterize the impact of frailty, as measured by the modified frailty index (mFI), on postoperative clinical and resource utilization outcomes in patients with IBD.MethodsThis retrospective population‐based cohort study assessed patients from the National Inpatient Sample database from 1 September 2015 to 31 December 2019. Corresponding International Classification of Diseases 10th Revision Clinical Modification codes were used to identify adult patients (>18 years of age) with IBD, undergoing either small bowel resection, colectomy or proctectomy. Patient demographics and institutional data were collected for each patient to calculate the 11‐point mFI. Patients were categorized as either frail or robust using a cut‐off of 0.27. Primary outcomes were postoperative in‐hospital morbidity and mortality, whilst secondary outcomes included system‐specific morbidity, length of stay, in‐hospital healthcare costs and discharge disposition. Logistic and linear regression models were used for primary and secondary outcomes.ResultsOverall, 7144 patients with IBD undergoing small bowel resection, colectomy or proctectomy were identified, 337 of whom were classified as frail (i.e., mFI < 0.27). Frail patients were more likely to be women, older, have lower income and a greater number of comorbidities. After adjusting for relevant covariates, frail patients were at greater odds of in‐hospital mortality (adjusted odds ratio [aOR] 5.42, 95% CI 2.31–12.77, P < 0.001), overall morbidity (aOR 1.72, 95% CI 1.30–2.28, P < 0.001), increased length of stay (adjusted mean difference 1.3 days, 95% CI 0.09–2.50, P = 0.035) and less likely to be discharged to home (aOR 0.59, 95% CI 0.45–0.77, P < 0.001) compared to their robust counterparts.ConclusionsFrail IBD patients are at greater risk of postoperative mortality and morbidity, and reduced likelihood of discharge to home, following surgery. This has implications for clinicians designing care pathways for IBD patients following surgery.

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Section: Methodsmentioning

confidence: 99%

Frailty in inflammatory bowel disease: analysis of the National Inpatient Sample 2015–2019

Sharma,

McKechnie,

Heimann

et al. 2024

Colorectal Disease

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“…The study group was further narrowed by identifying only CRC patients who underwent either colectomy, proctectomy or proctocolectomy on the given admission. The diagnosis and procedure codes utilized were drawn from previous similar studies [21][22][23] (see Table A1 in the Appendix for the detailed ICD-10-CM codes utilized to identify the cohort for this study).…”

Section: Cohort Selectionmentioning

confidence: 99%

The impact of operative approach for obese colorectal cancer patients: analysis of the National Inpatient Sample 2015–2019

Logie,

McKechnie,

Talwar

et al. 2023

Colorectal Disease

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AimObesity is a well‐established risk factor for the development of colorectal cancer. As such, patients undergoing surgery for colorectal cancer have increasingly higher body mass indices (BMIs). The advances in minimally invasive surgical techniques in recent years have helped surgeons circumvent some of the challenges associated with operating in the setting of obesity. While previous studies suggest that laparoscopy improves outcomes compared with open surgery in obese patients, this has never been established at the population level. Therefore, we designed a retrospective database study using the National Inpatient Sample (NIS) with the aim of comparing laparoscopic with open approaches for obese patients undergoing surgery for colorectal cancer.MethodA retrospective analysis of the NIS from 2015 to 2019 was conducted including patients with a BMI of greater than 30 kg/m2 undergoing surgery for colorectal cancer. The primary outcomes were postoperative in‐hospital morbidity and mortality. Secondary outcomes included postoperative system‐specific complications, total admission healthcare cost and length of stay (LOS). Multivariable logistic and linear regressions were utilized to compare the two operative approaches.ResultsA total of 4742 patients underwent open surgery and 3231 underwent laparoscopic surgery. We observed a significant decrease in overall postoperative morbidity [17.5% vs. 31.4%, adjusted odds ratio (aOR) 0.56, 95% confidence interval (CI) 0.50–0.64; p < 0.001], gastrointestinal morbidity (8.1% vs. 14.5%, aOR 0.59, 95% CI 0.50–0.69; p < 0.001) and genitourinary morbidity (10.1% vs. 18.6%, aOR 0.61, 95% CI 0.52–0.70; p < 0.001) with the use of laparoscopy. Postoperative LOS was 1.7 days shorter (95% CI 1.5–2.0, p < 0.001) and cost of admission was decreased by $9106 (95% CI $4638–$13 573, p < 0.001) with laparoscopy.ConclusionLaparoscopic surgery for obese patients with colorectal cancer is associated with significantly decreased postoperative morbidity and improved healthcare resource utilization compared with open surgery. Laparoscopic approaches should be relied upon whenever feasible for these patients.

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Short-term postoperative outcomes for obese versus non-obese inflammatory bowel disease patients undergoing bowel resection: a propensity score matched analysis

Park,

McKechnie,

Lee

et al. 2024

Int J Colorectal Dis

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Trends in utilization of laparoscopic colectomy according to race: an analysis of the NIS database

Cited by 8 publications

References 35 publications

Frailty in inflammatory bowel disease: analysis of the National Inpatient Sample 2015–2019

Frailty in inflammatory bowel disease: analysis of the National Inpatient Sample 2015–2019

The impact of operative approach for obese colorectal cancer patients: analysis of the National Inpatient Sample 2015–2019

Short-term postoperative outcomes for obese versus non-obese inflammatory bowel disease patients undergoing bowel resection: a propensity score matched analysis

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