Department of Surgery, Zealand University Hospital, Roskilde, Denmark.
Colorectal Dis. 2018 Dec;20(12):1097-1108. doi: 10.1111/codi.14446. Epub 2018 Nov 7.
The present database study aimed to identify patients with a longer postoperative length of stay (LOS) or patients readmitted and to characterize both groups based on perioperative factors.
A retrospective review of the Danish Colorectal Cancer Group database and a local database was performed of all patients undergoing elective resection for colorectal cancer in a 25-month period. The primary outcome was the number of patients with a prolonged hospital stay (LOS ≥ 10 days after the primary operation) and readmissions within 30 days after discharge.
A total of 372 patients with colon resection and 215 patients with rectal resection were included. Patients undergoing colonic resection had a rate of prolonged hospital stay of 10.6% and a readmission rate of 13.7%; prolonged hospital stay was significantly associated with age ≥ 76 years and those who underwent a conversion from a laparoscopic procedure. Patients undergoing rectal cancer resection had a rate of prolonged hospital stay of 17.7% and a readmission rate of 14.0%; Charlson comorbidity score (CCS) ≥ 2, total mesorectal excision (TME) and laparoscopic conversion were significantly associated with prolonged hospital stay, and American Society of Anesthesiologists (ASA) score ≥ 3, TME and a duration of surgery ≥ 300 min were significantly associated with readmission.
In patients with colon cancer, older age and conversion to open surgery were associated with prolonged hospital stay. In patients with rectal cancer, CCS ≥ 2, TME and conversion were associated with prolonged hospital stay, and a preoperative ASA score ≥ 3, TME and a duration of surgery ≥ 300 min were associated with readmission.
本数据库研究旨在确定术后住院时间较长（LOS）或再次入院的患者，并根据围手术期因素对这两组患者进行特征描述。
对丹麦结直肠癌组数据库和当地数据库进行回顾性分析，对 25 个月内接受择期结直肠癌切除术的所有患者进行分析。主要结果是 LOS 延长（主要手术后 10 天以上）和出院后 30 天内再次入院的患者数量。
共纳入 372 例结肠切除术患者和 215 例直肠切除术患者。结肠切除术患者的住院时间延长率为 10.6%，再入院率为 13.7%；年龄≥76 岁和腹腔镜手术转为开腹手术与住院时间延长显著相关。直肠切除术患者的住院时间延长率为 17.7%，再入院率为 14.0%；Charlson 合并症评分（CCS）≥2、全直肠系膜切除术（TME）和腹腔镜转为开腹手术与住院时间延长显著相关，ASA 评分≥3、TME 和手术时间≥300min 与再入院显著相关。
在结肠癌患者中，年龄较大和转为开腹手术与住院时间延长相关。在直肠癌患者中，CCS≥2、TME 和转为开腹手术与住院时间延长相关，术前 ASA 评分≥3、TME 和手术时间≥300min 与再入院相关。
