Factors associated with prolonged hospitalization in patients undergoing pancreatoduodenectomy

Michal Radomski, Mazen Zenati, Stephanie Novak, Vernissia Tam, Jennifer Steve, David L. Bartlett, Amer H. Zureikat, Herbert J. Zeh, Melissa E. Hogg

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: Complex surgeries such as a pancreatoduodenectomy (PD) traditionally have long hospital stays (LOS). Methods: Patients who underwent elective PD at our institution from 8/2011-6/2015 were retrospectively examined. Interquartile ranges were calculated from LOS. Patient were compared between the highest quartile and the remainder of the cohort. Results: 492 patients had a median LOS of 9 days, with 106 (22%) admitted for >14 days. Characteristics associated with prolong hospitalization include age (p = 0.004) and preoperative albumin <3.5 (p = 0.007). Significant intra-operative measures associated with prolonged LOS were blood loss (EBL, p = 0.004) and increased operative time (p = 0.008). Any complication extended hospitalizations (p < 0.001). Patients in the top quartile were less likely to be discharged home (p < 0.0001) and more likely to be readmitted (p < 0.0001). Conclusion: Older patients with hypoalbuminemia are at higher risk of prolonged LOS following PD as well as high EBL, operative time, and surgical complications. Focused efforts to counsel and optimize patients pre-operatively and minimize intra-operative complications may shorten hospital stays.

Original languageEnglish (US)
Pages (from-to)636-642
Number of pages7
JournalAmerican journal of surgery
Volume215
Issue number4
DOIs
StatePublished - Apr 2018
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Radomski, M., Zenati, M., Novak, S., Tam, V., Steve, J., Bartlett, D. L., Zureikat, A. H., Zeh, H. J., & Hogg, M. E. (2018). Factors associated with prolonged hospitalization in patients undergoing pancreatoduodenectomy. American journal of surgery, 215(4), 636-642. https://doi.org/10.1016/j.amjsurg.2017.06.040