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Factors Associated with Early Discharge after Non-Emergent Right Colectomy for Colon Cancer: A NSQIP Analysis

The National Surgical Quality Improvement Project (NSQIP) dataset was used to identify perioperative variables associated with the length of stay (LOS) and early discharge among cancer patients undergoing colectomy. Patients who underwent non-emergent right colectomy for colon cancer from 2012 to 20...

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Autores principales: Squires, Malcolm H., Donahue, Erin E., Wallander, Michelle L., Trufan, Sally J., Shea, Reilly E., Lindholm, Nicole F., Hill, Joshua S., Salo, Jonathan C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954992/
https://www.ncbi.nlm.nih.gov/pubmed/36826150
http://dx.doi.org/10.3390/curroncol30020189
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author Squires, Malcolm H.
Donahue, Erin E.
Wallander, Michelle L.
Trufan, Sally J.
Shea, Reilly E.
Lindholm, Nicole F.
Hill, Joshua S.
Salo, Jonathan C.
author_facet Squires, Malcolm H.
Donahue, Erin E.
Wallander, Michelle L.
Trufan, Sally J.
Shea, Reilly E.
Lindholm, Nicole F.
Hill, Joshua S.
Salo, Jonathan C.
author_sort Squires, Malcolm H.
collection PubMed
description The National Surgical Quality Improvement Project (NSQIP) dataset was used to identify perioperative variables associated with the length of stay (LOS) and early discharge among cancer patients undergoing colectomy. Patients who underwent non-emergent right colectomy for colon cancer from 2012 to 2019 were identified from the NSQIP and colectomy-targeted databases. Postoperative LOS was analyzed based on postoperative day (POD) of discharge, with patients grouped into Early Discharge (POD 0–2), Standard Discharge (POD 3–5), or Late Discharge (POD ≥ 6) cohorts. Multivariable ordinal logistic regression was performed to identify risk factors associated with early discharge. The NSQIP query yielded 26,072 patients: 3684 (14%) in the Early Discharge, 13,414 (52%) in the Standard Discharge, and 8974 (34%) in the Late Discharge cohorts. The median LOS was 4.0 days (IQR: 3.0–7.0). Thirty-day readmission rates were 7% for Early Discharge, 8% for Standard Discharge, and 12% for Late Discharge. On multivariable regression analysis, risk factors significantly associated with a shorter LOS included independent functional status, minimally invasive approach, and absence of ostomy or additional bowel resection (all p < 0.001). Perioperative variables can be used to develop a model to identify patients eligible for early discharge after right colectomy for colon cancer. Efforts to decrease the overall median length of stay should focus on optimization of modifiable risk factors.
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spelling pubmed-99549922023-02-25 Factors Associated with Early Discharge after Non-Emergent Right Colectomy for Colon Cancer: A NSQIP Analysis Squires, Malcolm H. Donahue, Erin E. Wallander, Michelle L. Trufan, Sally J. Shea, Reilly E. Lindholm, Nicole F. Hill, Joshua S. Salo, Jonathan C. Curr Oncol Article The National Surgical Quality Improvement Project (NSQIP) dataset was used to identify perioperative variables associated with the length of stay (LOS) and early discharge among cancer patients undergoing colectomy. Patients who underwent non-emergent right colectomy for colon cancer from 2012 to 2019 were identified from the NSQIP and colectomy-targeted databases. Postoperative LOS was analyzed based on postoperative day (POD) of discharge, with patients grouped into Early Discharge (POD 0–2), Standard Discharge (POD 3–5), or Late Discharge (POD ≥ 6) cohorts. Multivariable ordinal logistic regression was performed to identify risk factors associated with early discharge. The NSQIP query yielded 26,072 patients: 3684 (14%) in the Early Discharge, 13,414 (52%) in the Standard Discharge, and 8974 (34%) in the Late Discharge cohorts. The median LOS was 4.0 days (IQR: 3.0–7.0). Thirty-day readmission rates were 7% for Early Discharge, 8% for Standard Discharge, and 12% for Late Discharge. On multivariable regression analysis, risk factors significantly associated with a shorter LOS included independent functional status, minimally invasive approach, and absence of ostomy or additional bowel resection (all p < 0.001). Perioperative variables can be used to develop a model to identify patients eligible for early discharge after right colectomy for colon cancer. Efforts to decrease the overall median length of stay should focus on optimization of modifiable risk factors. MDPI 2023-02-18 /pmc/articles/PMC9954992/ /pubmed/36826150 http://dx.doi.org/10.3390/curroncol30020189 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Squires, Malcolm H.
Donahue, Erin E.
Wallander, Michelle L.
Trufan, Sally J.
Shea, Reilly E.
Lindholm, Nicole F.
Hill, Joshua S.
Salo, Jonathan C.
Factors Associated with Early Discharge after Non-Emergent Right Colectomy for Colon Cancer: A NSQIP Analysis
title Factors Associated with Early Discharge after Non-Emergent Right Colectomy for Colon Cancer: A NSQIP Analysis
title_full Factors Associated with Early Discharge after Non-Emergent Right Colectomy for Colon Cancer: A NSQIP Analysis
title_fullStr Factors Associated with Early Discharge after Non-Emergent Right Colectomy for Colon Cancer: A NSQIP Analysis
title_full_unstemmed Factors Associated with Early Discharge after Non-Emergent Right Colectomy for Colon Cancer: A NSQIP Analysis
title_short Factors Associated with Early Discharge after Non-Emergent Right Colectomy for Colon Cancer: A NSQIP Analysis
title_sort factors associated with early discharge after non-emergent right colectomy for colon cancer: a nsqip analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9954992/
https://www.ncbi.nlm.nih.gov/pubmed/36826150
http://dx.doi.org/10.3390/curroncol30020189
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