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择期结直肠手术后非临床长期住院的危险因素。

Risk factors for non-clinical prolonged lengths of stay after elective colorectal surgery.

作者信息

Gleaves Xuan, Tan Jarrod Kah Hwee, Peh Cherie Hui, Koh Wei-Ling, Lau Jerrald, Lieske Bettina, Cheong Wai Kit, Chan Dedrick Kok Hong, Tan Ker Kan

机构信息

University Surgical Cluster, National University Hospital, Singapore, Singapore.

Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

出版信息

Sci Rep. 2025 Mar 17;15(1):9184. doi: 10.1038/s41598-025-93013-5.

Abstract

Identification of reasons and causative factors for prolonged lengths of stay (LOS) after elective colorectal surgery in patients with uneventful postoperative recovery. A prospectively maintained database of colorectal cancer (CRC) patients between 2019 and 2021 was reviewed. Peri-operative parameters were evaluated to identify risk factors for prolonged LOS. Uneventful postoperative recovery was defined as Clavien-Dindo (CD) Complication Grade 0. 181 patients had uneventful postoperative recovery. 30 (16.7%) patients had delayed discharge, the underlying reasons were ongoing physiotherapy assessment for discharge (N = 11), caregiver training for stoma/drain (N = 6), family/patient confidence and or pending community placement for continuation of postoperative rehabilitation (N = 14). Factors such as pre-operative status of activity of daily living (ADL) and community ambulance, stoma creation, and high dependency (HD) ward admission were independently associated with delayed discharge. Multiple factors accounted for delayed discharge in in patients after elective surgery for CRC. Pre-operative identification and intervention to some of these factors might pave the way to reduce the overall length of hospitalization.

摘要

确定择期结直肠手术后恢复顺利的患者住院时间延长(LOS)的原因和致病因素。回顾了2019年至2021年间前瞻性维护的结直肠癌(CRC)患者数据库。评估围手术期参数以确定住院时间延长的风险因素。术后恢复顺利定义为Clavien-Dindo(CD)并发症0级。181例患者术后恢复顺利。30例(16.7%)患者出院延迟,根本原因是持续进行出院物理治疗评估(N = 11)、造口/引流护理人员培训(N = 6)、家庭/患者信心以及或等待社区安置以继续术后康复(N = 14)。术前日常生活活动(ADL)状态、社区救护车、造口形成和高依赖(HD)病房入院等因素与出院延迟独立相关。多种因素导致CRC择期手术后患者出院延迟。对其中一些因素进行术前识别和干预可能为缩短总体住院时间铺平道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e39/11914062/7fcd958acadb/41598_2025_93013_Fig1_HTML.jpg

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