Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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SHR Neuro Krebs Kardio Lipid Stoffw Microb

EuroSurg Collaborative.
Safety of hospital discharge before return of bowel function after elective colorectal surgery.
Br J Surg. 2020; 107(5): 552-559. Doi: 10.1002/bjs.11422
Web of Science PubMed FullText FullText_MUG

 

Study Group Mitglieder der Med Uni Graz:
Mikalauskas Saulius
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Abstract:
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.
Find related publications in this database (using NLM MeSH Indexing)
Adult - administration & dosage
Colectomy - administration & dosage
Colostomy - administration & dosage
Elective Surgical Procedures - administration & dosage
Female - administration & dosage
Follow-Up Studies - administration & dosage
Humans - administration & dosage
Ileostomy - administration & dosage
Ileus - etiology, physiopathology
Male - administration & dosage
Middle Aged - administration & dosage
Multivariate Analysis - administration & dosage
Patient Discharge - standards
Patient Readmission - statistics & numerical data
Patient Safety - standards, statistics & numerical data
Postoperative Complications - epidemiology, etiology, physiopathology
Proctectomy - administration & dosage
Prospective Studies - administration & dosage
Recovery of Function - administration & dosage

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