Risk factors affecting hospital stay among patients undergoing colon cancer surgery: a prospective cohort study
Por:
Orive, M, Aguirre, U, Gonzalez, N, Lazaro, S, Redondo, M, Bare, M, Anula, R, Briones, E, Escobar, A, Sarasqueta, C, Quintana, J, Lopez, J, Lopez, J, Manas, M, Bautista, M, de la Blanca, E, Baz, N, Eizaguirre, C, Martinez, A, Ruiz, F, Morales-Suarez-Varela, M, Amaro, J, Gonzalez, I, Madariaga, I, Gonzalez, A, Hernandez, N, Garcia-Gutierrez, S, Guerrero, I, Larracoechea, U, Calzada, M, Corral, J, Anton-Ladislao, A, Tora, N, Pont, M, del Prado, M, Totorikaguena, A, Estevez, I, Alustiza, J, Garcia, A, Aramburu, S, Serrano, M, Navascues, J, Galan, C, Perales, A, Valmana, I, Azkarate, J, Lizarribar, E, Munoa, A, Pibernat, P, Cuevas, E, Gomez, A, Gomez-Abril, S, Medina-Cano, F, Alcaide, J, Del Rey-Moreno, A, Alcantara, M, Campo, R, Casalots, A, Pericay, C, Gil, M, Pera, M, Collera, P, Espinas, J, Martinez, M, Espallargues, M, Almazan, C, Lindenbaum, P, Fernandez-Cebrian, J, Fernandez, R, Martinez, J, Cid, R, Labajo, H, Garceau, M, Olmo, D, Montalvo, M, Mar, J and REDISSEC-CARESS CCR Grp
Publicada:
1 nov 2019
Categoría:
Oncology
Resumen:
Purpose To identify and validate risk factors that contribute to prolonged length of hospital stay (LOS) in patients undergoing resection for colorectal cancer. Methods This prospective cohort study included 1955 patients admitted to 22 hospitals for primary resection of colorectal cancer. Multivariate analyses were used to identify and validate risk factors, randomizing patients into a derivation and a validation cohort. Multiple correspondence and cluster analysis were performed to identify clinical subtypes based on LOS. Results The strongest independent predictors of prolonged LOS were postoperative reintervention, surgical site infection, open surgery, and distant metastasis. The multiple correspondence and cluster analysis provided three groups of patients in relation to prolonged LOS: patients with the longest LOS included the highest percentage of patients with open surgery, distant metastasis, deep surgical site infections, emergency admissions, additional diagnostic factors, and highly contaminated surgical sites. Patients with prolonged LOS (> 14 days) were more likely to develop adverse outcomes within 30 days after discharge. Conclusions Patients undergoing resection of colorectal cancer cluster into different groups based on LOS of the index admission. Those with prolonged LOS were more likely to develop adverse outcomes within 30 days after discharge. Some of the strongest independent predictors of prolonged LOS, such as surgical infections or open surgery, could be modified to reduce LOS and, in turn, other adverse outcomes.
Filiaciones:
Orive, M:
Hosp Galdakao Usansolo, Res Unit, B Labeaga S-N, Galdakao 48960, Biscay, Spain
Hlth Serv Res Chron Patients Network REDISSEC, Baracaldo, Spain
Aguirre, U:
Hosp Galdakao Usansolo, Res Unit, B Labeaga S-N, Galdakao 48960, Biscay, Spain
Hlth Serv Res Chron Patients Network REDISSEC, Baracaldo, Spain
Gonzalez, N:
Hosp Galdakao Usansolo, Res Unit, B Labeaga S-N, Galdakao 48960, Biscay, Spain
Hlth Serv Res Chron Patients Network REDISSEC, Baracaldo, Spain
Lazaro, S:
Galdakao Usansolo Hosp, Gen Surg Serv, Galdakao, Bizkaia, Spain
Redondo, M:
Hlth Serv Res Chron Patients Network REDISSEC, Baracaldo, Spain
Hosp Costa del Sol, Res Unit, Malaga, Spain
Bare, M:
Hlth Serv Res Chron Patients Network REDISSEC, Baracaldo, Spain
Corp Parc Tauli, Clin Epidemiol Unit, Barcelona, Spain
Anula, R:
Hosp Clin San Carlos, Colorectal Unit, Madrid, Spain
Briones, E:
Dist AP Sevilla, UDG Publ Hlth, Seville, Spain
Escobar, A:
Hlth Serv Res Chron Patients Network REDISSEC, Baracaldo, Spain
Basurto Univ Hosp, Res Unit, Bilbao, Bizkaia, Spain
Sarasqueta, C:
Hlth Serv Res Chron Patients Network REDISSEC, Baracaldo, Spain
Donostia Univ Hosp, Res Unit, Donostia San Sebastian, Gipuzkoa, Spain
Quintana, J:
Hosp Galdakao Usansolo, Res Unit, B Labeaga S-N, Galdakao 48960, Biscay, Spain
Hlth Serv Res Chron Patients Network REDISSEC, Baracaldo, Spain
Lopez, J:
Hosp Galdakao Usansolo, Unidad Invest, Galdakao Bizkaia, Spain
Manas, M:
Corp Sanitaria Parc Tauli, Epidemiol Clin & Cribado Canc, Sabadell, Spain
Bautista, M:
Hosp Costa del Sol, Serv Lab, Malaga, Spain
de la Blanca, E:
Dist Sevilla, Unidad Epidemiol, Serv Andaluz Salud, Seville, Spain
Baz, N:
Inst Salud Carlos III, Ctr Nacl Epidemiol, Madrid, Spain
CIBER Epidemiol & Salud Publ, Madrid, Spain
Eizaguirre, C:
Hosp Univ Donostia, Unidad Invest, Donostia San Sebastian, Spain
Inst Invest Sanitaria Biodonostia, Donostia San Sebastian, Spain
Martinez, A:
Hosp Univ Basurto, Unidad Invest, Bilbao, Spain
Ruiz, F:
Hosp Costa del Sol, Serv Epidemiol, Malaga, Spain
:
Univ Valencia, Dept Prevent Med & Publ Hlth, Valencia, Spain
CSISP FISABIO, CIBER Epidemiol & Salud Publ CIBERESP, Valencia, Spain
Amaro, J:
Agencia Lain Entralgo, Unidad Evaluac Tecnol Sanitarias, Madrid, Spain
Gonzalez, I:
Consejeria Sanidad Comunidad Autonoma Madrid, Gerencia Atenc Primaria, Gerencia Adjunta Planificac, Unidad Apoyo Docencia Invest,Direcc Tecn Docencia, Madrid, Spain
Madariaga, I:
Univ Politecn Valencia, Dept Matemat Aplicada Estad & Invest Operat, Valencia, Spain
Gonzalez, A:
Hosp Univ Basurto, Unidad Invest, Bilbao, Spain
Hernandez, N:
Hosp Galdakao Usansolo, Unidad Invest, Galdakao Bizkaia, Spain
Garcia-Gutierrez, S:
Hosp Galdakao Usansolo, Res Unit, B Labeaga S-N, Galdakao 48960, Biscay, Spain
Hlth Serv Res Chron Patients Network REDISSEC, Baracaldo, Spain
Hosp Galdakao Usansolo, Unidad Invest, Galdakao Bizkaia, Spain
Guerrero, I:
Hosp Galdakao Usansolo, Unidad Invest, Galdakao Bizkaia, Spain
Larracoechea, U:
Hosp Galdakao Usansolo, Unidad Invest, Galdakao Bizkaia, Spain
Calzada, M:
Hosp Galdakao Usansolo, Unidad Invest, Galdakao Bizkaia, Spain
Corral, J:
Hosp Galdakao Usansolo, Unidad Invest, Galdakao Bizkaia, Spain
Anton-Ladislao, A:
Hosp Galdakao Usansolo, Unidad Invest, Galdakao Bizkaia, Spain
Tora, N:
Corp Sanitaria Parc Tauli, Epidemiol Clin & Cribado Canc, Sabadell, Spain
Pont, M:
Corp Sanitaria Parc Tauli, Epidemiol Clin & Cribado Canc, Sabadell, Spain
del Prado, M:
Hosp Univ Basurto, Serv Oncol, Bilbao, Spain
Totorikaguena, A:
Hosp Univ Basurto, Serv Cirugia Gen, Bilbao, Spain
Estevez, I:
Hosp Galdakao Usansolo, Serv Anat Patol, Galdakao, Spain
Alustiza, J:
Hosp Univ Araba, Serv Cirugia Gen, Vitoria, Spain
Garcia, A:
Hosp Univ Canarias, Serv Gastroenterol, San Cristobal la Laguna, Spain
Aramburu, S:
Hosp Galdakao Usansolo, Serv Cirugia Gen, Galdakao, Spain
Serrano, M:
Hosp del Mar, IMAS, Barcelona, Spain
Navascues, J:
Hosp Univ Donostia, Serv Cirugia Gen & Digest, Donostia San Sebastian, Spain
Galan, C:
Hosp Univ Donostia, Serv Cirugia Gen & Digest, Donostia San Sebastian, Spain
Perales, A:
Inst Investigac Sanitaria Biodonostia, Donostia San Sebastian, Spain
Valmana, I:
Hosp Mendaro, Serv Cirugia Gen & Digest, Mendaro, Spain
Azkarate, J:
Hosp Zumarraga, Serv Cirugia Gen & Digest, Zumarraga, Spain
Lizarribar, E:
Hosp Bidasoa, Serv Cirugia Gen & Digest, Hondarribia, Spain
Munoa, A:
Hosp Univ Donostia, Serv Oncol Med, Donostia San Sebastian, Spain
Pibernat, P:
Hosp Univ Donostia, Serv Oncol Med, Donostia San Sebastian, Spain
Cuevas, E:
Hosp Univ Virgen del Rocio, Inst Biomed Sevilla, Seville, Spain
Gomez, A:
Hosp Univ Virgen de Valme, Serv Cirugia, Seville, Spain
:
Hosp Dr Pesset, Serv Cirugia Gen & Aparato Digest, Valencia, Spain
Medina-Cano, F:
Agencia Sanitaria Costa Sol, Serv Cirugia Gen & Aparato Digest, Marbella, Spain
Alcaide, J:
Agencia Sanitaria Costa Sol, Serv Oncol Med, Marbella, Spain
Del Rey-Moreno, A:
Hosp Antequera, Serv Cirugia, Malaga, Spain
Alcantara, M:
Corp Sanitaria Parc Tauli, Gen & Digest Surg Serv, Coloproctol Unit, Sabadell, Spain
Campo, R:
Corp Sanitaria Parc Tauli, Digest Dis Dept, Sabadell, Spain
Casalots, A:
Corp Sanitaria Parc Tauli, Pathol Serv, Sabadell, Spain
Pericay, C:
Corp Sanitaria Parc Tauli, Med Oncol Dept, Sabadell, Spain
Gil, M:
Parc Salut Mar, Gen & Digest Surg Serv, Barcelona, Spain
Pera, M:
Parc Salut Mar, Gen & Digest Surg Serv, Barcelona, Spain
Collera, P:
Althaia Xarxa Assistencial Univ, Gen & Digest Surg Serv, Manresa, Spain
Espinas, J:
Inst Catala Oncol, Dept Hlth, Catalonian Canc Strategy Unit, Barcelona, Spain
Martinez, M:
Inst Catala Oncol, Med Oncol Dept, Barcelona, Spain
Espallargues, M:
Agcy Hlth Qual & Assessment Catalonia AquAS, Barcelona, Spain
Almazan, C:
Agcy Hlth Qual & Assessment Catalonia AquAS, CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain
Lindenbaum, P:
Hosp Univ Fdn Alcorcon, Serv Cirugia Gen & Aparato Digest, Madrid, Spain
Fernandez-Cebrian, J:
Hosp Univ Fdn Alcorcon, Serv Cirugia Gen & Aparato Digest, Madrid, Spain
Fernandez, R:
Hosp Univ Clin San Carlos, Serv Cirugia Gen & Aparato Digest, Madrid, Spain
Martinez, J:
Hosp Univ Clin San Carlos, Serv Cirugia Gen & Aparato Digest, Madrid, Spain
Cid, R:
Hosp Univ Infanta Sofia, Serv Cirugia Gen & Aparato Digest, Madrid, Spain
Labajo, H:
Hosp Univ La Paz, Serv Cirugia Gen & Aparato Digest, Madrid, Spain
Garceau, M:
Hosp Univ La Paz, Serv Cirugia Gen & Aparato Digest, Madrid, Spain
Olmo, D:
Hosp Univ La Paz, Serv Cirugia Gen & Aparato Digest, Madrid, Spain
Montalvo, M:
Gerencia Asistencial Atenc Primaria Comunidad Mad, Unidad Apoyo Invest, REDISSEC, Madrid, Spain
Mar, J:
Hosp Alto Deba, Unidad Gest Sanitaria, REDISSEC, Mondragon Arrasate, Spain
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