scholarly journals Effect of Delay to Surgery on Mortality, Length of Stay and Post-Operative Complications in Hip Fracture Patients

2010 ◽  
Vol 8 (7) ◽  
pp. 515
Author(s):  
Reshid Berber ◽  
Chris Boulton ◽  
Christopher Moran
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Operative Complications ◽  
Post Operative Complications

MP69-05 EVALUATION OF POST-OPERATIVE COMPLICATIONS AND PROLONGED LENGTH OF STAY FOLLOWING CYTOREDUCTIVE NEPHRECTOMY

2015 ◽  
Vol 193 (4S) ◽  
Author(s):  
Boris Gershman ◽  
Daniel Moreira ◽  
Stephen Boorjian ◽  
Christine Lohse ◽  
John Cheville ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Cytoreductive Nephrectomy ◽  
Prolonged Length ◽  
Operative Complications ◽  
Post Operative Complications

Cranioplasty length of stay: Relationship with indication, surgical decision-making factors, and sex

Trauma ◽  
2019 ◽  
Vol 22 (4) ◽  
pp. 256-264
Author(s):  
Weston Northam ◽  
Avinash Chandran ◽  
Crystal Adams ◽  
Nikki E. Barczak-Scarboro ◽  
Carolyn Quinsey
Keyword(s):  
Decision Making ◽  
Length Of Stay ◽  
Average Length ◽  
Surgical Decision ◽  
Average Length Of Stay ◽  
Covariate Effects ◽  
Operative Complications ◽  
Decision Making Factors ◽  
Surgical Decision Making ◽  
Post Operative Complications

Objectives Cranioplasty is being performed more often due to rising rates of decompressive craniectomy. Hospital length of stay is a quality metric which has not been directly studied after cranioplasty. This study aims to identify factors associated with length of stay after cranioplasty to better understand their outcomes. Patients and methods A retrospective review was conducted at a single academic center from 2007 to 2015 for all patients >18 years of age who received cranioplasty. Baseline data from 148 patients were recorded including demographics, clinical characteristics, and surgeon decision-making factors for cranioplasty. Post-operative complications within 30 days after cranioplasty were recorded in addition to disposition and discharge data. Weibull accelerated failure time models were used to identify significant associations with length of stay after cranioplasty. Results The overall post-operative complication rate was 27.0%, and the most frequent indication for craniectomy was traumatic brain injury. The majority (72.3%) of patients returned home, compared to other disposition, and median length of stay was 2.0 days (interquartile range = 2.0). Average length of stay was 7.7 days in men, as compared with 2.4 days in women, and even upon adjusting for covariate effects, length of stay was longer in men than in women irrespective of post-operative complications. When time-to-cranioplasty fell between 0 and 30 days, average length of stay was 19.2 days, as compared with 10.3 days when time-to-cranioplasty fell between 30 and 90 days, and 2.5 days when time-to-cranioplasty was >90 days. After adjustment for covariate effects, the association between time-to-cranioplasty and length of stay was maintained only in patients without post-operative complications. Conclusions Length of stay can inform our understanding of outcomes after cranioplasty. In our study, length of stay was associated with sex, indication for craniectomy, and surgical decision-making (time-to-cranioplasty and implant material), but time-to-cranioplasty was only associated in patients without post-operative complications. These relationships should be seen not as direct causation, but rather as tools to add to our understanding of this relatively complicated procedure.

1626 SARCOPENIA PREDICTS POST-OPERATIVE COMPLICATIONS AND LENGTH OF STAY FOLLOWING RADICAL CYSTECTOMY

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
Janine Oliver ◽  
Goutham Vemana ◽  
Joel Vetter ◽  
Seth Strope ◽  
Christine Menias ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Radical Cystectomy ◽  
Operative Complications ◽  
Post Operative Complications

Impact of hospital type and surgical volume on outcomes of biliary cancer resection.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16168-e16168
Author(s):  
Jasmeet Kaur ◽  
Waqas Qureshi ◽  
Vaibhav Sahai
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Healthcare Cost ◽  
Hospital Volume ◽  
Teaching Hospitals ◽  
Biliary Cancer ◽  
Cancer Resection ◽  
Operative Complications ◽  
Teaching Status ◽  
Post Operative Complications

e16168 Background: The mainstay of treatment for patients with early-stage biliary cancer (gallbladder or cholangiocarcinoma) is surgical resection. Herein, we evaluated the predictors for biliary cancer resection outcome and association with hospital volume and teaching status. Methods: A national representative cohort of 18485 biliary cancer patients was included for the years 2016 – 2018 from the national inpatient sample database. The study population included patients ≥ 18 years diagnosed with biliary cancer who underwent elective surgical resection (ICD 10). Hospitals were categorized based on teaching status (yes, if ACGME approved residency program, member of the council of teaching hospitals, or with residents to beds ratio of .25 or higher, versus non-teaching); and hospital volume (high if ≥ 20 biliary cancer surgeries performed per year, otherwise low). The primary outcome was biliary resection and the secondary outcomes included post-operative complications, in-hospital mortality, length of stay (< or ≥ 7 days), and health care cost (< or ≥ median) based on hospital teaching status and biliary cancer surgical volume. Association with outcomes was assessed using multivariable logistic regression models adjusted for age, sex, race, household income, service payer, Elixhauser co-morbidity score, hospital volume, teaching status, bed size, location, and region. Results: Out of 18,485 patients hospitalized with biliary cancer, 7,030 patients underwent elective biliary cancer resection during the study period. Patients undergoing resection were likely to have higher than national household median income with Medicare as primary insurance payor. In multivariate adjusted logistic regression models, high volume centers showed significantly lower length of stay (adjusted odds ratio (aOR) 0.73; 95% CI 0.54 - 0.97; p=0.03), and lower in-hospital mortality (aOR 0.28; 95% CI 0.15 - 0.80; p=0.01), but no significant difference in post-operative complications or healthcare cost compared to low volume centers. Surgeries performed in a teaching hospital were associated with decreased risk of post-operative complications (aOR 0.74; 95% CI 0.55 - 1.0; p=0.05), significant decrease in in-hospital mortality (aOR 0.44; 95% CI 0.27 - 0.69; p=0.001), but higher inflation-adjusted healthcare cost (aOR 1.77; 95% CI 1.37-2.26; p<0.001) with no difference in length of stay. Conclusions: Patients who underwent elective biliary cancer surgery at a teaching or high-volume hospital had a significant decrease in their risk of in-hospital mortality. Additionally, surgeries at teaching hospitals were associated with a significantly lower post-operative complication rate compared to similar procedures at a non-teaching hospital, although teaching hospitals did have a significantly higher healthcare cost when adjusted for length of stay.

Impact of compliance with an enhanced recovery after surgery pathway on patient outcomes in open gynecologic surgery

2019 ◽  
Vol 29 (9) ◽  
pp. 1417-1424 ◽  
Author(s):  
Maria D Iniesta ◽  
Javier Lasala ◽  
Gabriel Mena ◽  
Andrea Rodriguez-Restrepo ◽  
Gloria Salvo ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Surgery ◽  
Complication Rates ◽  
Operative Outcomes ◽  
Tertiary Center ◽  
Operative Complications ◽  
Eras Protocol ◽  
Post Operative Complications

ObjectiveThe aim of this study was to evaluate if varying levels of compliance with an enhanced recovery after surgery (ERAS) protocol impacted post-operative outcomes (length of stay, complications, readmissions, and re-operations) in gynecologic surgery at a tertiary center.MethodsWe included 584 patients who had open gynecologic surgery between November 1, 2014 and December 31, 2016. Patients were categorized into subgroups according to their date of surgery from the time of the ERAS protocol implementation. Patients were categorized by their per cent compliance into two groups:<80% versus ≥80%. We analyzed compliance with the elements of the protocol over time and its relation with post-operative outcomes, length of stay, post-operative complications, readmission, and re-operations rates. We modeled the probability of having a post-operative complication within 30 days of surgery as a function of overall compliance.ResultsOverall compliance was 72.3%. Patients with compliance ≥80% had significantly less complications (P<0.001) and shorter length of stay (P<0.001). Readmission and re-operation rates were not impacted by compliance (P=0.182, P=0.078, respectively). Avoidance of salt water overload, early mobilization, early oral nutrition, and early removal of Foley catheter were significantly associated with less post-operative complications within 30 days.ConclusionsCompliance with an ERAS pathway exceeding 80% was associated with lower complication rates and shorter length of stay without impacting on re-operations or readmissions.

scholarly journals P-BN61 Optimal timing of laparoscopic cholecystectomy for admitted acute cholecystitis patients

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
James Lucocq ◽  
John Scollay ◽  
Pradeep Patil
Keyword(s):  
Logistic Regression ◽  
Laparoscopic Cholecystectomy ◽  
Length Of Stay ◽  
Acute Cholecystitis ◽  
Regression Models ◽  
Multivariate Logistic Regression ◽  
Logistic Regression Models ◽  
Total Length ◽  
Operative Complications ◽  
Post Operative Complications

Abstract Background The Tokyo 2018 guidelines support emergency laparoscopic cholecystectomy (ELC) for acute cholecystitis (AC) over delayed laparoscopic cholecystectomy (DLC) for mild cholecystitis, substantiated by a lower total length of stay. The supporting studies are limited by small sample sizes, and clinically relevant findings may have been missed. The aims of the present paper were firstly, to compare the peri- and post-operative course following emergency and delayed LC for AC. Methods All patients who underwent ELC and DLC for AC following hospital admission between January 2015 and December 2019 were included in the study. Pre-operative, operative and post-operative data over a 100-day follow-up period were collected retrospectively from multiple databases using a deterministic records-linkage methodology. Patients were splint into groups based on previous admissions and outcomes were compared between ELC and DLC. Multivariate logistic regression models were then used on the entire cohort to adjust for other variables and to determine the impact of ELC versus DLC. Complications of the category Clavien-Dindo ≥2 were considered. Results In the group with no previous admissions (n = 630), DCL patients had lower rates of intra-/post-operative complications (8.0%vs.17.9%;p&lt;0.001), lower rates of re-admission (6.6%vs.12.2%;p=0.04) and longer total length of stay (6dvs.5d;p=0.03). In patients with previous admissions (n = 181), DCL had lower rates of intra-/post-operative complications (14.1%vs.25.5%;p=0.06) but there was no significant difference in length of stay (13dvs.12d;p=0.81). The ELC group had a significantly lower admission CRP, ASA and age (p &lt; 0.001). In the multivariate logistic regression models, ELC was positively associated with subtotal/conversion to open (OR,1.94;p=0.01), drain insertion (OR,2.54;p&lt;0.001), bile leak (OR,2.38;p&lt;0.001), post-operative imaging (OR,1.83;p=0.01), longer post-operative stay (OR,7.26,p&lt;0.001) and readmission (OR-1.9;p=0.01).  Conclusions DLC, once the period of active inflammation has settled, offers superior post-operative outcomes, including lower rates of complication, re-admission and post-operative length of stay; however is associated with longer total length of stay. DLC is only advised where the risk of re-admission is minimised (i.e surgery six weeks following the episode) and relies on the management of surgical waiting lists.

scholarly journals Impact of albumin levels on clinical outcomes in children underwent abdominal surgery

2020 ◽  
Vol 60 (3) ◽  
pp. 149-53
Author(s):  
Rismala Dewi ◽  
Freddy Guntur Mangapul Silitonga ◽  
Irawan Mangunatmadja
Keyword(s):  
Length Of Stay ◽  
Abdominal Surgery ◽  
Serum Albumin ◽  
Clinical Outcomes ◽  
Postoperative Mortality ◽  
Increased Risk ◽  
Operative Complications ◽  
The Impact ◽  
Post Operative Complications

Background Patients underwent abdominal surgery and had hypoalbuminemia were at risk of post-operative complications. The prognostic role of albumin levels in children with abdominal surgery remains unclear. Objective To investigate the impact of albumin levels on clinical outcomes related to the complications in children with abdominal surgery. Methods This was a retrospective cohort study on children aged 29 days to 18 years, who underwent abdominal surgery, had serum albumin levels measured at pre-operative and within 48 hours post-operatively, and hospitalized in Paediatric Intensive Care Unit of Dr. Cipto Mangunkusumo Hospital, Indonesia. The primary outcomes were post-operative complications (sepsis, surgical site infection, shock), length of stay in PICU, dehiscence, relaparotomy, and postoperative mortality. Results This study recruited a total of 201 children. Pre- and post-operative serum albumin levels of ≤ 3.00 g/dL were found in 15.4% and 51.2%, respectively. Pre- and post-operative serum albumin levels of ≤ 3.00 g/dL were associated with higher risk of post-operative sepsis (RR 3.4; 95%CI 1.54 to 7.51) and relaparotomy (RR 3.84; 95%CI 1.28 to 1.49). The median of length of PICU stay was 4 days longer in children with pre-operative serum albumin levels ≤ 3.00 g/dL (P<0.001). Conclusions Hypoalbuminemia condition in children undergo abdominal surgery is associated with increased risk of post-operative sepsis, longer length of stay in PICU, and risk of relaparotomy.

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