title: Fast-track program for liver resection--factors prolonging length of stay.
abstract: OBJECTIVE
  Fast-track programs involving multi-modal measures to enhance recovery after surgery, reduce morbidity and decrease hospital length of stay (LOS) are used for different major surgical procedures. For liver resections, factors influencing LOS within a fast-track program have been studied only to a limited extent, which was the aim of the present study.
  
  
  METHODS
  The present study comprises the first 64 patients included in a fast-track program for liver resections introduced in March 2012. Patient outcomes were compared to a historical cohort of patients (n=62) operated in 2009. Factors prolonging LOS was analyzed by uni- and multivariate analysis.
  
  
  RESULTS
  Median LOS was 6 days (range 3-42 days) within the fast-track program as compared with 8 days (range 5-47 days) in the historical cohort (P=0.004). On multivariate analysis, factors increasing LOS in the fast-track group were found to be the presence of complication (P=0.018), extent of resection (major as compared to minor) (P=0.001) and inability to drink > 1250 ml on the day after surgery (P=0.002).
  
  
  CONCLUSIONS
  Patients who can only drink limited amounts of fluid the day after liver resection represent a subset of patients that should be given special attention within a fast-track program.
authors.forename: Per-Jonas
authors.initials: PJ
authors.lastname: Blind
authors.forename: Bodil
authors.initials: B
authors.lastname: Andersson
authors.forename: Bobby
authors.initials: B
authors.lastname: Tingstedt
authors.forename: Magnus
authors.initials: M
authors.lastname: Bergenfeldt
authors.forename: Roland
authors.initials: R
authors.lastname: Andersson
authors.forename: Gert
authors.initials: G
authors.lastname: Lindell
authors.forename: Christian
authors.initials: C
authors.lastname: Sturesson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged