PMID- 27893655
OWN - NLM
STAT- MEDLINE
DCOM- 20170213
LR  - 20220410
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 47
DP  - 2016 Nov
TI  - A retrospective observational study of length of stay in hospital after 
      colorectal cancer surgery in England (1998-2010).
PG  - e5064
LID - 10.1097/MD.0000000000005064 [doi]
LID - e5064
AB  - The National Health Service (NHS) is facing financial constraints and thus there 
      is considerable interest in ensuring the shortest but optimal hospital stays 
      possible. The aim of this study was to investigate patterns of postoperative 
      length of stay (LOS) stay across the English NHS and to identify factors that 
      significantly influence both optimal and prolonged LOS.Data were obtained from 
      the National Cancer Data Repository (NCDR). National patterns of LOS were 
      examined and multilevel mixed effects logistic regression was used to study 
      factors associated with an "ideal" (</=5 days) or a prolonged (>/=21 days) LOS in 
      hospital after major resection. Funnel plots were used to examine variation 
      across hospitals in both risk-adjusted and unadjusted LOS.All 240,873 individuals 
      who underwent major resection for colorectal cancer were diagnosed between 1998 
      and 2010 in the English NHS. The overall median LOS was 10 (interquartile range 
      [IQR] 7-14 days) days, but it fell over time from 11 (IQR 9-15) days in 1998 to 7 
      (IQR 5-12) days in 2010. The proportion of people experiencing "ideal" LOS 
      increased dramatically from 4.9% in 1998 to 34.2% in 2010, but the decrease in 
      the proportion of patients who experienced a prolonged LOS was less marked 
      falling from 11.2% to 8.4%, respectively. Control charts showed that there was 
      significant variation in short and prolonged LOS across NHS trusts even after 
      adjustment for case-mix.Significant variation in LOS existed between NHS 
      hospitals in England throughout period 1998 to 2010. Understanding the underlying 
      causes of this variation between surgical providers will make it possible to 
      identify and spread best practice, improve services, and ultimately reduce LOS 
      following colorectal cancer surgery.
FAU - Aravani, Ariadni
AU  - Aravani A
AD  - Cancer Epidemiology Group, Section of Epidemiology and Biostatistics, Leeds 
      Institute of Cancer & Pathology, University of Leeds Knowledge and Intelligence 
      Team (Northern & Yorkshire) National Cancer Registration Service (Northern & 
      Yorkshire), Public Health England Leeds Institute of Cancer & Pathology, 
      University of Leeds, St James's University Hospital, Leeds, UK.
FAU - Samy, Elizabeth F
AU  - Samy EF
FAU - Thomas, James D
AU  - Thomas JD
FAU - Quirke, Phil
AU  - Quirke P
FAU - Morris, Eva J A
AU  - Morris EJA
FAU - Finan, Paul J
AU  - Finan PJ
LA  - eng
GR  - MR/L01629X/1/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Colorectal Neoplasms/epidemiology/*surgery
MH  - Colorectal Surgery/*statistics & numerical data
MH  - England/epidemiology
MH  - Female
MH  - Humans
MH  - Length of Stay/*statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - State Medicine
PMC - PMC5134848
COIS- The authors report no conflicts of interest.
EDAT- 2016/11/29 06:00
MHDA- 2017/02/14 06:00
PMCR- 2016/11/28
CRDT- 2016/11/29 06:00
PHST- 2016/11/29 06:00 [entrez]
PHST- 2016/11/29 06:00 [pubmed]
PHST- 2017/02/14 06:00 [medline]
PHST- 2016/11/28 00:00 [pmc-release]
AID - 00005792-201611220-00005 [pii]
AID - MD-D-16-04117 [pii]
AID - 10.1097/MD.0000000000005064 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Nov;95(47):e5064. doi: 10.1097/MD.0000000000005064.