The impact of complications on prolonged length of hospital stay after resection in colorectal cancer: A retrospective study of Taiwanese patients.
Objectives To assess the impact of minor, major and individual complications on prolonged length of hospital stay in patients with colorectal cancer (CRC) after surgery using multivariate models. Methods This was a retrospective review of data from patients who underwent surgery for stage I-III CRC at two medical centres in southern Taiwan between 2005-2010. Information was derived from four databases. Multivariate logistic regression methods were used to assess the impact of complications on prolonged length of stay (PLOS) and prolonged postoperative length of stay (PPOLOS). Results Of 1658 study patients, 251 (15.1%) experienced minor or major postsurgical complications during hospitalizations. Minor and major complications were significantly associated with PLOS (minor, odds ratio [OR] 3.59; major, OR 8.82) and with PPOLOS (minor, OR 5.55; major, OR 10.00). Intestinal obstruction, anastomosis leakage, abdominal abscess and bleeding produced the greatest impact. Conclusions Minor and major complications were stronger predictors of prolonged hospital stay than preoperative demographic and disease parameters. Compared with the PLOS model, the PPOLOS model better predicted risk of prolonged hospital stay. Optimal surgical and medical care have major roles in surgical CRC patients.
1 Research Education and Epidemiology Centre, Changhua Christian Hospital, Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.|2 Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan.
Herng-Chia
HC
Chiu
3 Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
Yi-Chieh
YC
Lin
4 Department of Colorectal Surgery, E-DA Hospital, Kaohsiung, Taiwan.
Hui-Min
HM
Hsieh
5 Department of Medical Affairs, E-DA Hospital, Kaohsiung, Taiwan.
Hsin-Pao
HP
Chen
5 Department of Medical Affairs, E-DA Hospital, Kaohsiung, Taiwan.
Hui-Li
HL
Wang
6 Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|7 Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|8 Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Jaw-Yuan
JY
Wang
D018784:Abdominal Abscess / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000175:diagnosis* / Q000473:pathology; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan
Complications; Taiwan; colorectal cancer; prolonged length of stay (PLOS); prolonged postoperative length of stay (PPOLOS)