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Risk Factors for Nonhome Discharge After Esophagectomy for Neoplastic Disease. Ann Thorac Surg 2021 Apr;111(4):1118-1124

Date

09/01/2020

Pubmed ID

32866477

Pubmed Central ID

PMC9295198

DOI

10.1016/j.athoracsur.2020.06.066

Scopus ID

2-s2.0-85101515581 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

BACKGROUND: Esophagectomies are known to be technically challenging operations that create significant physiologic changes. These patients often require assisted care postoperatively that necessitates a nonhome discharge. The purpose of this study was to assess factors associated with nonhome discharge after esophagectomy for neoplastic disease.

METHODS: The 2016 to 2017 American College of Surgeons National Surgical Quality Improvement Program Esophagectomy database was queried to identify patients who underwent esophagectomy for a neoplasm. Patients were excluded if they died within 30 days of their operation, the index operation was considered emergent, or had missing data for the variables of interest. Multivariable analysis was performed to identify which factors were predictive of nonhome discharge.

RESULTS: One thousand seven patients were included. Of those, 121 (12.0%) had a nonhome discharge. Multivariable analysis showed that the following factors were associated with nonhome discharge: Modified Charlson comorbidity index (adjusted odds ratio [aOR], 2.04; 95% confidence interval [CI], 1.49-2.86), partially dependent preoperative functional status (aOR, 13.18; 95% CI, 1.07-315.67), urinary tract infection (aOR, 5.25; 95% CI, 1.32-20.41), and length of stay (aOR, 1.12; 95% CI, 1.08-1.16).

CONCLUSIONS: We identified various factors associated with nonhome discharge. Early identification of patients who are at risk for nonhome discharge is important for early discharge planning, which may decrease nonmedical delays and healthcare costs.

Author List

Heid CA, Khoury MK, Thornton MA, Geoffrion TR, De Hoyos AL

Author

Tracy R. Geoffrion MD Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Esophageal Neoplasms
Esophagectomy
Female
Follow-Up Studies
Humans
Male
Patient Discharge
Patient Readmission
Postoperative Period
Retrospective Studies
Risk Factors