PMID- 22448728
OWN - NLM
STAT- MEDLINE
DCOM- 20120622
LR  - 20220410
IS  - 1472-6963 (Electronic)
IS  - 1472-6963 (Linking)
VI  - 12
DP  - 2012 Mar 26
TI  - Factors predicting hospital length-of-stay and readmission after colorectal 
      resection: a population-based study of elective and emergency admissions.
PG  - 77
LID - 10.1186/1472-6963-12-77 [doi]
AB  - BACKGROUND: The impact of developments in colorectal cancer surgery on 
      length-of-stay (LOS) and re-admission have not been well described. In a 
      population-based analysis, we investigated predictors of LOS and emergency 
      readmission after the initial surgery episode. METHODS: Incident colorectal 
      cancers (ICD-O2: C18-C20), diagnosed 2002-2008, were identified from the National 
      Cancer Registry Ireland, and linked to hospital in-patient episodes. For those 
      who underwent colorectal resection, the associated hospital episode was 
      identified. Factors predicting longer LOS (upper-quartile, > 24 days) for 
      elective and emergency admissions separately, and whether LOS predicted emergency 
      readmission within 28 days of discharge, were investigated using logistic 
      regression. RESULTS: 8197 patients underwent resection, 63% (n = 5133) elective 
      and 37% (n = 3063) emergency admissions. Median LOS was 14 days (inter-quartile 
      range (IQR) = 11-20) for elective and 21 (15-33) for emergency admissions. For 
      both emergency and elective admissions, likelihood of longer LOS was 
      significantly higher in patients who were older, had co-morbidities and were 
      unmarried; it was reduced for private patients. For emergency patients only the 
      likelihood of longer LOS was lower for patients admitted to higher-volume 
      hospitals. Longer LOS was associated with increased risk of emergency 
      readmission. CONCLUSIONS: One quarter of patients stay in hospital for at least 
      25 days following colorectal resection. Over one third of resected patients are 
      emergency admissions and these have a significantly longer median LOS. Patient- 
      and health service-related factors were associated with prolonged LOS. Longer LOS 
      was associated with increased risk of emergency readmission. The cost 
      implications of these findings are significant.
FAU - Kelly, Maria
AU  - Kelly M
AD  - National Cancer Registry, Building 6800, Cork Airport Business Park, Cork, 
      Ireland. m.kelly@ncri.ie
FAU - Sharp, Linda
AU  - Sharp L
FAU - Dwane, Fiona
AU  - Dwane F
FAU - Kelleher, Tracy
AU  - Kelleher T
FAU - Comber, Harry
AU  - Comber H
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120326
PL  - England
TA  - BMC Health Serv Res
JT  - BMC health services research
JID - 101088677
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Colorectal Neoplasms/epidemiology/physiopathology/*surgery
MH  - Comorbidity
MH  - Emergency Medical Services/*statistics & numerical data
MH  - Female
MH  - Hospitals, Private
MH  - Hospitals, Public
MH  - Humans
MH  - Ireland/epidemiology
MH  - Length of Stay/*statistics & numerical data/trends
MH  - Male
MH  - Middle Aged
MH  - Patient Readmission/*statistics & numerical data/trends
MH  - Population Surveillance
MH  - Postoperative Complications/etiology
MH  - Preoperative Care/statistics & numerical data
MH  - Registries
MH  - Waiting Lists
PMC - PMC3341181
EDAT- 2012/03/28 06:00
MHDA- 2012/06/23 06:00
PMCR- 2012/03/26
CRDT- 2012/03/28 06:00
PHST- 2011/11/03 00:00 [received]
PHST- 2012/03/26 00:00 [accepted]
PHST- 2012/03/28 06:00 [entrez]
PHST- 2012/03/28 06:00 [pubmed]
PHST- 2012/06/23 06:00 [medline]
PHST- 2012/03/26 00:00 [pmc-release]
AID - 1472-6963-12-77 [pii]
AID - 10.1186/1472-6963-12-77 [doi]
PST - epublish
SO  - BMC Health Serv Res. 2012 Mar 26;12:77. doi: 10.1186/1472-6963-12-77.