Predictors of discharge destination after complex abdominal wall reconstruction
Autor: | Amanda Chow, Edward S. Lee, Thuy-My T Le, Joseph S. Weisberger, Haripriya S. Ayyala |
---|---|
Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Univariate analysis Multivariate analysis business.industry Separation (statistics) MEDLINE 030230 surgery Logistic regression medicine.disease Surgery Sepsis 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis medicine business Body mass index Abdominal surgery |
Zdroj: | Hernia. 24:251-256 |
ISSN: | 1248-9204 1265-4906 |
Popis: | Complex ventral hernia repair is a common operation performed in a diverse population. Post-operatively, patients may have a prolonged length of stay pending facility placement. With increasing in-patient volumes, the authors aim to identify risk factors for non-home discharge to expedite placement applications and decrease length of stay. The ACS-NSQIP database was queried for all ventral hernia repairs with separation of components performed between 2005 and 2016, excluding patients that left against medical advice or expired. Multivariate logistic regression was performed to identify independent risk factors for discharge to a facility as well as the risk for post-discharge complications following discharge to a facility after univariate analysis to compare demographics, comorbidities, and complications. Independent sample t test was done to compare mean age, body mass index and length of stay. 4549 patients met inclusion criteria. Pre-operative factors significantly associated with non-home discharge on multivariate analysis were female gender, history of diabetes, history of hypertension, older age (60+), presence of pre-operative wound infection/contaminated wound, sepsis, and dependent functional status. Intra-operative factors included ASA classification of 3 or 4 and longer operative time. Our study was able to identify several predictive factors, mostly pre-operative, that increase the likelihood that a patient will require discharge to a facility after complex ventral hernia repair. Identification of these factors can expedite patient discharge disposition resulting in decreased length of stay, less hospital-acquired conditions, and minimized health care costs. |
Databáze: | OpenAIRE |
Externí odkaz: |