Clinical Factors Associated with Longer Hospital Stay Following Ovarian Cancer Surgery
<i>Background</i>: Ovarian cancer (OC) is the leading cause of death from gynecologic malignancy and is treated with a combination of cytoreductive surgery and platinum-based chemotherapy. Extended length of stay (LOS) after surgery can affect patient morbidity, overall costs, and hospit...
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MDPI AG
2019-07-01
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Series: | Healthcare |
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Online Access: | https://www.mdpi.com/2227-9032/7/3/85 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Christopher G. Smith Daniel L. Davenport Justin Gorski Anthony McDowell Brian T. Burgess Tricia I. Fredericks Lauren A. Baldwin Rachel W. Miller Christopher P. DeSimone Charles S. Dietrich Holly H. Gallion Edward J. Pavlik John R. van Nagell Frederick R. Ueland |
spellingShingle |
Christopher G. Smith Daniel L. Davenport Justin Gorski Anthony McDowell Brian T. Burgess Tricia I. Fredericks Lauren A. Baldwin Rachel W. Miller Christopher P. DeSimone Charles S. Dietrich Holly H. Gallion Edward J. Pavlik John R. van Nagell Frederick R. Ueland Clinical Factors Associated with Longer Hospital Stay Following Ovarian Cancer Surgery Healthcare ovarian cancer length of stay ACS-NSQIP blood transfusion neoadjuvant chemotherapy interval debulking surgery primary cytoreductive surgery |
author_facet |
Christopher G. Smith Daniel L. Davenport Justin Gorski Anthony McDowell Brian T. Burgess Tricia I. Fredericks Lauren A. Baldwin Rachel W. Miller Christopher P. DeSimone Charles S. Dietrich Holly H. Gallion Edward J. Pavlik John R. van Nagell Frederick R. Ueland |
author_sort |
Christopher G. Smith |
title |
Clinical Factors Associated with Longer Hospital Stay Following Ovarian Cancer Surgery |
title_short |
Clinical Factors Associated with Longer Hospital Stay Following Ovarian Cancer Surgery |
title_full |
Clinical Factors Associated with Longer Hospital Stay Following Ovarian Cancer Surgery |
title_fullStr |
Clinical Factors Associated with Longer Hospital Stay Following Ovarian Cancer Surgery |
title_full_unstemmed |
Clinical Factors Associated with Longer Hospital Stay Following Ovarian Cancer Surgery |
title_sort |
clinical factors associated with longer hospital stay following ovarian cancer surgery |
publisher |
MDPI AG |
series |
Healthcare |
issn |
2227-9032 |
publishDate |
2019-07-01 |
description |
<i>Background</i>: Ovarian cancer (OC) is the leading cause of death from gynecologic malignancy and is treated with a combination of cytoreductive surgery and platinum-based chemotherapy. Extended length of stay (LOS) after surgery can affect patient morbidity, overall costs, and hospital resource utilization. The primary objective of this study was to identify factors contributing to prolonged LOS for women undergoing surgery for ovarian cancer. <i>Methods</i>: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried to identify women from 2012−2016 who underwent hysterectomy for ovarian, fallopian tube and peritoneal cancer. The primary outcome was LOS >50th percentile. Preoperative and intraoperative variables were examined to determine which were associated with prolonged LOS. <i>Results</i>: From 2012−2016, 1771 women underwent elective abdominal surgery for OC and were entered in the ACS-NSQIP database. The mean and median LOS was 4.6 and 4.0 days (IQR 0−38), respectively. On multivariate analysis, factors associated with prolonged LOS included: American Society of Anesthesiologists (ASA) Classification III (aOR 1.71, 95% CI 1.38−2.13) or IV (aOR 1.88, 95% CI 1.44−2.46), presence of ascites (aOR 1.88, 95% CI 1.44−2.46), older age (aOR 1.23, 95% CI 1.13−1.35), platelet count >400,000/mm<sup>3</sup> (aOR 1.74, 95% CI 1.29−2.35), preoperative blood transfusion (aOR 11.00, 95% CI 1.28−94.77), disseminated cancer (aOR 1.28, 95% CI 1.03−1.60), increased length of operation (121−180 min, aOR 1.47, 95% CI 1.13-1.91; >180 min, aOR 2.78, 95% CI 2.13−3.64), and postoperative blood transfusion within 72 h of incision (aOR 2.04, 95% CI 1.59−2.62) (<i>p</i> < 0.05 for all). <i>Conclusions</i>: Longer length of hospital stay following surgery for OC is associated with many patient, disease, and treatment-related factors. The extent of surgery, as evidenced by perioperative blood transfusion and length of surgical procedure, is a factor that can potentially be modified to shorten LOS, improve patient outcomes, and reduce hospital costs. |
topic |
ovarian cancer length of stay ACS-NSQIP blood transfusion neoadjuvant chemotherapy interval debulking surgery primary cytoreductive surgery |
url |
https://www.mdpi.com/2227-9032/7/3/85 |
work_keys_str_mv |
AT christophergsmith clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT danielldavenport clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT justingorski clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT anthonymcdowell clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT briantburgess clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT triciaifredericks clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT laurenabaldwin clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT rachelwmiller clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT christopherpdesimone clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT charlessdietrich clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT hollyhgallion clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT edwardjpavlik clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT johnrvannagell clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery AT frederickrueland clinicalfactorsassociatedwithlongerhospitalstayfollowingovariancancersurgery |
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doaj-eeb11e32ce1d433082c2bf6d097393a32020-11-24T22:09:32ZengMDPI AGHealthcare2227-90322019-07-01738510.3390/healthcare7030085healthcare7030085Clinical Factors Associated with Longer Hospital Stay Following Ovarian Cancer SurgeryChristopher G. Smith0Daniel L. Davenport1Justin Gorski2Anthony McDowell3Brian T. Burgess4Tricia I. Fredericks5Lauren A. Baldwin6Rachel W. Miller7Christopher P. DeSimone8Charles S. Dietrich9Holly H. Gallion10Edward J. Pavlik11John R. van Nagell12Frederick R. Ueland13Department of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Surgery, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USADepartment of Obstetrics & Gynecology, University of Kentucky, Lexington, KY 40536-0293, USA<i>Background</i>: Ovarian cancer (OC) is the leading cause of death from gynecologic malignancy and is treated with a combination of cytoreductive surgery and platinum-based chemotherapy. Extended length of stay (LOS) after surgery can affect patient morbidity, overall costs, and hospital resource utilization. The primary objective of this study was to identify factors contributing to prolonged LOS for women undergoing surgery for ovarian cancer. <i>Methods</i>: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried to identify women from 2012−2016 who underwent hysterectomy for ovarian, fallopian tube and peritoneal cancer. The primary outcome was LOS >50th percentile. Preoperative and intraoperative variables were examined to determine which were associated with prolonged LOS. <i>Results</i>: From 2012−2016, 1771 women underwent elective abdominal surgery for OC and were entered in the ACS-NSQIP database. The mean and median LOS was 4.6 and 4.0 days (IQR 0−38), respectively. On multivariate analysis, factors associated with prolonged LOS included: American Society of Anesthesiologists (ASA) Classification III (aOR 1.71, 95% CI 1.38−2.13) or IV (aOR 1.88, 95% CI 1.44−2.46), presence of ascites (aOR 1.88, 95% CI 1.44−2.46), older age (aOR 1.23, 95% CI 1.13−1.35), platelet count >400,000/mm<sup>3</sup> (aOR 1.74, 95% CI 1.29−2.35), preoperative blood transfusion (aOR 11.00, 95% CI 1.28−94.77), disseminated cancer (aOR 1.28, 95% CI 1.03−1.60), increased length of operation (121−180 min, aOR 1.47, 95% CI 1.13-1.91; >180 min, aOR 2.78, 95% CI 2.13−3.64), and postoperative blood transfusion within 72 h of incision (aOR 2.04, 95% CI 1.59−2.62) (<i>p</i> < 0.05 for all). <i>Conclusions</i>: Longer length of hospital stay following surgery for OC is associated with many patient, disease, and treatment-related factors. The extent of surgery, as evidenced by perioperative blood transfusion and length of surgical procedure, is a factor that can potentially be modified to shorten LOS, improve patient outcomes, and reduce hospital costs.https://www.mdpi.com/2227-9032/7/3/85ovarian cancerlength of stayACS-NSQIPblood transfusionneoadjuvant chemotherapyinterval debulking surgeryprimary cytoreductive surgery |