Factors influencing discharge disposition after colectomy

Factors influencing discharge disposition after colectomy Background Factors associated with discharge destination after colectomy despite accounting for surgical morbidity have not previously been well characterized. This study aims to evaluate perioperative predictors for extended care after compli- cated and uncomplicated colectomy. Methods Patients admitted from home for elective colectomy were identified from the American College of Surgeons, National Surgical Quality Improvement Program, 2012–2013 general and colectomy-targeted datasets. Patients who were discharged home (DH) were compared to those discharged to facility (DF) for patient, disease, treatment, and pre-discharge postoperative adverse events. Patients without any 30-day postoperative complication were similarly compared. Results Of 19,527 patients undergoing elective colectomy, 18,128 (92.8%) were discharged home and 1399 (7.2%) patients to other facilities. When there was no postoperative complication, these rates were 96.3 and 3.7%, respectively. On multi- variable analysis, factors associated with DF included female gender, functional dependence, weight loss, ASA class ≥ 3, open and stoma surgery, and development of postoperative complications. For patients without postoperative complica- tions, increasing age, functional dependence, and ASA score ≥ 3 were associated with DF. Preoperative bowel preparation, albumin, a minimally invasive surgical approach, and length of stay < 5 days were significantly associated with reduced DF. Conclusion The majority of perioperative http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Surgical Endoscopy Springer Journals

Factors influencing discharge disposition after colectomy

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Publisher
Springer Journals
Copyright
Copyright © 2017 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Surgery; Gynecology; Gastroenterology; Hepatology; Proctology; Abdominal Surgery
ISSN
0930-2794
eISSN
1432-2218
D.O.I.
10.1007/s00464-017-6013-z
Publisher site
See Article on Publisher Site

Abstract

Background Factors associated with discharge destination after colectomy despite accounting for surgical morbidity have not previously been well characterized. This study aims to evaluate perioperative predictors for extended care after compli- cated and uncomplicated colectomy. Methods Patients admitted from home for elective colectomy were identified from the American College of Surgeons, National Surgical Quality Improvement Program, 2012–2013 general and colectomy-targeted datasets. Patients who were discharged home (DH) were compared to those discharged to facility (DF) for patient, disease, treatment, and pre-discharge postoperative adverse events. Patients without any 30-day postoperative complication were similarly compared. Results Of 19,527 patients undergoing elective colectomy, 18,128 (92.8%) were discharged home and 1399 (7.2%) patients to other facilities. When there was no postoperative complication, these rates were 96.3 and 3.7%, respectively. On multi- variable analysis, factors associated with DF included female gender, functional dependence, weight loss, ASA class ≥ 3, open and stoma surgery, and development of postoperative complications. For patients without postoperative complica- tions, increasing age, functional dependence, and ASA score ≥ 3 were associated with DF. Preoperative bowel preparation, albumin, a minimally invasive surgical approach, and length of stay < 5 days were significantly associated with reduced DF. Conclusion The majority of perioperative

Journal

Surgical EndoscopySpringer Journals

Published: Dec 27, 2017

References

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