Risk factors for prolonged hospitalization in patients undergoing laparoscopic adrenalectomy
Autor: | Krzysztof Przęczek, Magdalena Pisarska, Michał Natkaniec, Dorota Radkowiak, Andrzej Budzyński, Piotr Małczak, Piotr Major, Jadwiga Dworak, Michał Pędziwiatr, Michał Wysocki |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
Multivariate analysis Names of the days of the week Urology medicine.medical_treatment laparoscopy 030230 surgery Logistic regression Pheochromocytoma 03 medical and health sciences 0302 clinical medicine medicine In patient Laparoscopy Original Paper medicine.diagnostic_test business.industry Adrenalectomy Gastroenterology Obstetrics and Gynecology adrenalectomy medicine.disease Comorbidity Surgery 030220 oncology & carcinogenesis prolonged hospitalization business adrenal tumour |
Zdroj: | Videosurgery and other Miniinvasive Techniques |
Popis: | Introduction Even though laparoscopic adrenalectomy is currently a standard, there are important variations between different centres in short-term treatment results such as length of hospital stay (LOS) or morbidity. Aim To determine the factors affecting LOS in patients after laparoscopic transperitoneal lateral adrenalectomy (LTA). Material and methods The study enrolled 453 patients (173 men and 280 women, mean age 57 years) who underwent LTA between 2009 and 2017. Discharge from hospital after more than median hospital stay was considered as prolonged LOS. We evaluated factors that potentially may influence LOS (primary length of stay after surgery, excluding readmissions). Logistic regression models were used in univariate and corrected multivariate analyses, in order to identify the factors related to prolonged LOS. Results The median LOS after LTA in the studied group was 2 days. One hundred seventy-five (38.5%) patients required prolonged hospitalization. Univariate logistic regression showed that the following factors were related to prolonged LOS: presence of any comorbidity, cardiovascular disease, intraoperative complications, postoperative complications, day of the week of operation (surgery on Thursday or Friday), intraoperative blood loss, need for transfusion, hormonal activity, postoperative drainage, ASA (III-IV) and histological type - pheochromocytoma. Multivariate logistic regression showed that only complications (OR = 3.86; 95% CI: 1.84-8.04), day of the week of operation (Thursday or Friday) (OR = 4.85; 95% CI: 3.04-7.73), need for drainage (OR = 3.63; 95% CI: 1.55-8.52), and histological type - pheochromocytoma (OR = 2.48; 95% CI: 1.35-4.54) prolonged LOS. Conclusions Prolonged length of hospital stay following laparoscopic transperitoneal lateral adrenalectomy is strongly associated with the presence of postoperative complications, day of the week of operation (Thursday or Friday), need for drainage, and histological type - pheochromocytoma. |
Databáze: | OpenAIRE |
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