title: Predicting prolonged hospital stay after laparoscopic cholecystectomy.
abstract: BACKGROUND
  Widespread application of laparoscopic cholecystectomy (LC) has resulted in a high complication rate and leads to prolonged hospital stays. This study aimed to investigate the preoperative and intraoperative clinical factors that relate to prolongation of hospital stay.
  
  
  METHODS
  We studied 370 patients who underwent LC for gallbladder disease between 2008 and 2012. Clinical risk factors were retrospectively collected. The clinical pathway for LC was indicated for all patients, and they were divided into two groups according to postoperative length of stay (LOS): the normal duration group (LOS ≤5 days) and the long duration (LD) group (LOS ≥6 days). Multiple regression analysis was used to predict risk factors that identified hospital prolongation to create a LOS prediction score.
  
  
  RESULTS
  The normal duration group was 236 patients and the LD group was 134. Seventeen patients (4.6%) required conversion from laparoscopic to open surgery. LOS was 4.82 days in the normal duration group and 12.08 days in the LD group. In the LD group, 18.7% of the patients stayed more than 14 days, but no patients were readmitted. Thirteen clinical factors were statistically different between the two groups. ASA score and LC difficulty were the most predictive risk factors for LOS prolongation. LOS prediction score consisted of eight variables selected from 13 factors; it helped determine the likelihood of whether a patients' hospital stay was prolonged (sensitivity, 82.1%; specificity, 75.0%).
  
  
  CONCLUSIONS
  Thirteen factors closely related to hospital stay duration and LOS prediction score could predict the prolongation of a patient's hospital stay.
authors: Department of Surgery, Japan Community Healthcare Organization (JCHO), Osaka Hospital, Osaka, Japan.
authors: Yoshikazu
authors: Y
authors: Morimoto
authors: Department of Surgery, Japan Community Healthcare Organization (JCHO), Osaka Hospital, Osaka, Japan.
authors: Hitoshi
authors: H
authors: Mizuno
authors: Department of Surgery, Japan Community Healthcare Organization (JCHO), Osaka Hospital, Osaka, Japan.
authors: Yusuke
authors: Y
authors: Akamaru
authors: Department of Surgery, Japan Community Healthcare Organization (JCHO), Osaka Hospital, Osaka, Japan.
authors: Keigo
authors: K
authors: Yasumasa
authors: Department of Surgery, Japan Community Healthcare Organization (JCHO), Osaka Hospital, Osaka, Japan.
authors: Hiroshi
authors: H
authors: Noro
authors: Department of Surgery, Japan Community Healthcare Organization (JCHO), Osaka Hospital, Osaka, Japan.
authors: Emiko
authors: E
authors: Kono
authors: Department of Surgery, Japan Community Healthcare Organization (JCHO), Osaka Hospital, Osaka, Japan.
authors: Yoshio
authors: Y
authors: Yamasaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D017081:Cholecystectomy, Laparoscopic; D003661:Decision Support Techniques; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D057234:Preoperative Period; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Laparoscopic cholecystectomy; length of stay; prediction score