Predictors of length of stay for inpatients having benign gynaecological surgery.
OBJECTIVE
To determine factors predictive of length of stay (LOS) for women in case-mix group (CMG) 579 (major uterine and [or] adnexal procedures-no malignancy).


METHODS
All inpatients having benign gynaecologic surgery in CMG 579 between April 1, 1997, and March 30, 1999, were studied. We obtained information from the hospital costing and registration database and from retrospective chart review. Abstracted data included patient demographics, age, admission weight, American Society of Anesthesiologists (ASA) risk score, pre- and postoperative diagnoses, procedure, surgeon, day of the week of surgery, LOS, and costs. Results were considered statistically significant when P </= 0.05.


RESULTS
There were 606 gynaecology inpatients in the study, with a mean age of 45.1 years. Women were categorized into 4 procedure groups: abdominal (59.2%), vaginal (26.7%), abdominal repair (pelvic floor relaxation) (9.5%), and other (4.6%) forms of surgery. The LOS was highly correlated with overall case costs. Univariable analyses indicated that procedure (R(2) = 0.22, P < 0.001), age (R(2) = 0.12, P < 0.001), surgeon (R(2) = 0.11, P < 0.001), postoperative diagnosis (R(2) = 0.11, P < 0.001), ASA score (R(2) = 0.09, P < 0.001), day of the week of surgery (R(2) = 0.03, P < 0.018), and weight (R(2) = 0.01, P < 0.017) were all determinants of LOS (all P < 0.001). Multivariable analyses demonstrated that the procedure, age, surgeon, postoperative diagnosis, and ASA score were the significant factors accounting for the most variance in LOS (R(2) = 0.46, P < 0.001).


CONCLUSIONS
The procedure performed, patient's age, surgeon, postoperative diagnosis, and ASA score were significantly associated with length of stay. For better accuracy and validity, CMG-based comparisons of LOS should take these factors into account.
Victory
Rahi
R
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Western Ontario and London Health Sciences Centre, London, ON.
Carey
Mark S
MS
Stitt
Larry
L
D000328:Adult; D000367:Age Factors; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008875:Middle Aged; D010820:Physicians; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D012044:Regression Analysis; D013997:Time Factors; D014592:Uterine Hemorrhage / Q000601:surgery