Safety of hospital discharge before return of bowel function after elective colorectal surgery
© 2020 BJS Society Ltd Published by John Wiley & Sons Ltd..
BACKGROUND: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.
METHODS: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.
RESULTS: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110).
CONCLUSION: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:107 |
|---|---|
| Enthalten in: |
The British journal of surgery - 107(2020), 5 vom: 26. Apr., Seite 552-559 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
EuroSurg Collaborative [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 29.09.2021 Date Revised 09.05.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1002/bjs.11422 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM305734342 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM305734342 | ||
| 003 | DE-627 | ||
| 005 | 20231225121827.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/bjs.11422 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1019.xml |
| 035 | |a (DE-627)NLM305734342 | ||
| 035 | |a (NLM)31976560 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 0 | |a EuroSurg Collaborative |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Safety of hospital discharge before return of bowel function after elective colorectal surgery |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.09.2021 | ||
| 500 | |a Date Revised 09.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 BJS Society Ltd Published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function | ||
| 520 | |a METHODS: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system | ||
| 520 | |a RESULTS: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110) | ||
| 520 | |a CONCLUSION: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 700 | 1 | |a Chapman, S J |e investigator |4 oth | |
| 700 | 1 | |a Blanco-Colino, R |e investigator |4 oth | |
| 700 | 1 | |a Pérez-Ajates, S |e investigator |4 oth | |
| 700 | 1 | |a Anabitarte Bautista, O |e investigator |4 oth | |
| 700 | 1 | |a Hodson, J |e investigator |4 oth | |
| 700 | 1 | |a Blanco-Colino, R |e investigator |4 oth | |
| 700 | 1 | |a Chapman, S J |e investigator |4 oth | |
| 700 | 1 | |a Glasbey, J C |e investigator |4 oth | |
| 700 | 1 | |a Pata, F |e investigator |4 oth | |
| 700 | 1 | |a Pellino, G |e investigator |4 oth | |
| 700 | 1 | |a Sgrò, A |e investigator |4 oth | |
| 700 | 1 | |a Soares, A |e investigator |4 oth | |
| 700 | 1 | |a van Elst, T |e investigator |4 oth | |
| 700 | 1 | |a Van Straten, S |e investigator |4 oth | |
| 700 | 1 | |a Nepogodiev, D |e investigator |4 oth | |
| 700 | 1 | |a Hodson, J |e investigator |4 oth | |
| 700 | 1 | |a Borakati, A |e investigator |4 oth | |
| 700 | 1 | |a Bath, M F |e investigator |4 oth | |
| 700 | 1 | |a Yasin, I H |e investigator |4 oth | |
| 700 | 1 | |a Mclean, K |e investigator |4 oth | |
| 700 | 1 | |a Arthur, T |e investigator |4 oth | |
| 700 | 1 | |a Kovacevic, M |e investigator |4 oth | |
| 700 | 1 | |a Delibegovic, S |e investigator |4 oth | |
| 700 | 1 | |a Karamanliev, M |e investigator |4 oth | |
| 700 | 1 | |a Swamad, M |e investigator |4 oth | |
| 700 | 1 | |a Žebrák, R |e investigator |4 oth | |
| 700 | 1 | |a Paramasivam, R |e investigator |4 oth | |
| 700 | 1 | |a Martensen, A |e investigator |4 oth | |
| 700 | 1 | |a Larsen, H M |e investigator |4 oth | |
| 700 | 1 | |a Rädeker, L |e investigator |4 oth | |
| 700 | 1 | |a Frey, P E |e investigator |4 oth | |
| 700 | 1 | |a Kechagias, A |e investigator |4 oth | |
| 700 | 1 | |a Venara, A |e investigator |4 oth | |
| 700 | 1 | |a Duchalais, E |e investigator |4 oth | |
| 700 | 1 | |a Ioannidis, A |e investigator |4 oth | |
| 700 | 1 | |a Pata, F |e investigator |4 oth | |
| 700 | 1 | |a Pellino, G |e investigator |4 oth | |
| 700 | 1 | |a Pasquali, S |e investigator |4 oth | |
| 700 | 1 | |a Sgrò, A |e investigator |4 oth | |
| 700 | 1 | |a Simioni, A |e investigator |4 oth | |
| 700 | 1 | |a Farina, V |e investigator |4 oth | |
| 700 | 1 | |a Podda, M |e investigator |4 oth | |
| 700 | 1 | |a Lorenzon, L |e investigator |4 oth | |
| 700 | 1 | |a Schaeff, V |e investigator |4 oth | |
| 700 | 1 | |a Otto, A |e investigator |4 oth | |
| 700 | 1 | |a Jakubauskas, M |e investigator |4 oth | |
| 700 | 1 | |a van Elst, T R |e investigator |4 oth | |
| 700 | 1 | |a Chu, M |e investigator |4 oth | |
| 700 | 1 | |a Fagan, Pvb |e investigator |4 oth | |
| 700 | 1 | |a Wells, C I |e investigator |4 oth | |
| 700 | 1 | |a Alagoa João, A |e investigator |4 oth | |
| 700 | 1 | |a Soares, A |e investigator |4 oth | |
| 700 | 1 | |a Juloski, J |e investigator |4 oth | |
| 700 | 1 | |a Blanco-Colino, R |e investigator |4 oth | |
| 700 | 1 | |a Pérez-Ajates, S |e investigator |4 oth | |
| 700 | 1 | |a Anabitarte Bautista, O |e investigator |4 oth | |
| 700 | 1 | |a El Kasmy El Kasmi, Y |e investigator |4 oth | |
| 700 | 1 | |a Espin-Basany, E |e investigator |4 oth | |
| 700 | 1 | |a Clerc, D |e investigator |4 oth | |
| 700 | 1 | |a Ciubotaru, C |e investigator |4 oth | |
| 700 | 1 | |a Popescu, S |e investigator |4 oth | |
| 700 | 1 | |a Yanishev, A |e investigator |4 oth | |
| 700 | 1 | |a Lee, S |e investigator |4 oth | |
| 700 | 1 | |a Ozkan, B B |e investigator |4 oth | |
| 700 | 1 | |a Yagız Sen, A |e investigator |4 oth | |
| 700 | 1 | |a Aktas, M K |e investigator |4 oth | |
| 700 | 1 | |a Baki, B E |e investigator |4 oth | |
| 700 | 1 | |a Yüksek, B |e investigator |4 oth | |
| 700 | 1 | |a Glasbey, J C |e investigator |4 oth | |
| 700 | 1 | |a Kamarajah, S |e investigator |4 oth | |
| 700 | 1 | |a Mclean, K |e investigator |4 oth | |
| 700 | 1 | |a Borakati, A |e investigator |4 oth | |
| 700 | 1 | |a Yasin, I H |e investigator |4 oth | |
| 700 | 1 | |a Khaw, R A |e investigator |4 oth | |
| 700 | 1 | |a Mills, E |e investigator |4 oth | |
| 700 | 1 | |a Goodson, R |e investigator |4 oth | |
| 700 | 1 | |a Thakral, N |e investigator |4 oth | |
| 700 | 1 | |a Ablett, A D |e investigator |4 oth | |
| 700 | 1 | |a Adra, M |e investigator |4 oth | |
| 700 | 1 | |a Kwek, I |e investigator |4 oth | |
| 700 | 1 | |a Khan, S M |e investigator |4 oth | |
| 700 | 1 | |a Quinn, P |e investigator |4 oth | |
| 700 | 1 | |a Manley, L R |e investigator |4 oth | |
| 700 | 1 | |a Badran, A |e investigator |4 oth | |
| 700 | 1 | |a Ramjeeawon, A |e investigator |4 oth | |
| 700 | 1 | |a Campbell, A |e investigator |4 oth | |
| 700 | 1 | |a Tan, H L |e investigator |4 oth | |
| 700 | 1 | |a Rye, D S |e investigator |4 oth | |
| 700 | 1 | |a Rajaraman, N |e investigator |4 oth | |
| 700 | 1 | |a Norman, J G |e investigator |4 oth | |
| 700 | 1 | |a Vutipongsatorn, K |e investigator |4 oth | |
| 700 | 1 | |a Solomou, G |e investigator |4 oth | |
| 700 | 1 | |a Akhbari, M |e investigator |4 oth | |
| 700 | 1 | |a Ali, A |e investigator |4 oth | |
| 700 | 1 | |a Murray, V |e investigator |4 oth | |
| 700 | 1 | |a Baker, D M |e investigator |4 oth | |
| 700 | 1 | |a Brandao, B D |e investigator |4 oth | |
| 700 | 1 | |a Stainer, B |e investigator |4 oth | |
| 700 | 1 | |a Thavayogan, R |e investigator |4 oth | |
| 700 | 1 | |a Jones, D |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t The British journal of surgery |d 1945 |g 107(2020), 5 vom: 26. Apr., Seite 552-559 |w (DE-627)NLM000001465 |x 1365-2168 |7 nnns |
| 773 | 1 | 8 | |g volume:107 |g year:2020 |g number:5 |g day:26 |g month:04 |g pages:552-559 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/bjs.11422 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 107 |j 2020 |e 5 |b 26 |c 04 |h 552-559 | ||