title: Predicting inpatient stay lasting 2 midnights or longer after robotic surgery for endometrial cancer.
abstract: OBJECTIVE
  To estimate the rate of inpatient stay and the factors predicting inpatient status after robotic surgery for endometrial cancer following the change in the Medicare definition of "inpatient" to include hospitalization spanning 2 midnights.
  
  
  METHODS
  Retrospective chart review (Canadian Task Force classification II-1).
  
  
  METHODS
  Academic hospital.
  
  
  METHODS
  All patients (n = 395) with endometrial cancer who underwent robotic surgical management between 2006 and 2010.
  
  
  METHODS
  The outpatient stay group with hospitalization spanning 1 midnight was compared with the inpatient stay group with hospitalization spanning 2 midnights or longer through estimation of the adjusted relative risk (aRR) for various characteristics of interest.
  
  
  RESULTS
  Ninety-six of 395 patients (24.3%) stayed at least 2 midnights and thus were deemed inpatients. Clinical factors associated with inpatient stay were increasing age, history of myocardial infarction (aRR, 2.0; 95% confidence interval [CI], 1.0-3.7), surgery start time at or after 12 noon (aRR, 1.7; 95% CI, 1.2-2.4), perioperative blood transfusion (aRR, 3.2; 95% CI, 2.3-4.5), and surgery performed in the year 2010 (aRR, 0.5; 95% CI, 0.3-0.7). Age ≥ 60 years was associated with at least a 2-fold adjusted risk of prolonged hospitalization. Body mass index, other medical comorbidities, operative duration, estimated blood loss, and performance of lymphadenectomy or additional surgical procedures were not identified as significant risk factors.
  
  
  CONCLUSIONS
  Approximately 75% of the patients undergoing robotic surgery for endometrial cancer were discharged as outpatients. Recognition of factors predicting inpatient stay can improve hospital resource allocation and throughput in women undergoing robotic surgery for endometrial cancer.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Margaret I
authors.initials: MI
authors.lastname: Liang
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Maggie A
authors.initials: MA
authors.lastname: Rosen
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Kellie S
authors.initials: KS
authors.lastname: Rath
authors.affiliation: Center for Biostatistics, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Erinn M
authors.initials: EM
authors.lastname: Hade
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Aine E
authors.initials: AE
authors.lastname: Clements
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Floor J
authors.initials: FJ
authors.lastname: Backes
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Eisenhauer
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Ritu
authors.initials: R
authors.lastname: Salani
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: David M
authors.initials: DM
authors.lastname: O'Malley
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Fowler
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio. Electronic address: David.Cohn@osumc.edu.
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
mesh_terms: D000368:Aged; D015992:Body Mass Index; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008197:Lymph Node Excision; D010045:Outpatients / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012371:Robotics
keywords: Endometrial cancer; Inpatient stay; Prolonged hospitalization; Robotic surgery