Preoperative factors prolonging the length of stay in elective colorectal surgery

In elective colorectal resections, the patient's preoperative social situation may play a significant role in delaying their discharge from hospital. The aim of this study was to identify which preoperative factors are associated with non-medical reasons for a delay in discharge and prolonged length of stay (LOS) in hospital after elective colorectal resections.

A retrospective review of prospectively collected data was performed on all the elective colorectal resections done at Westmead Hospital for over 2 years between 2007 and 2008. LOS, whether there was a delay in discharge because of non-medical reasons, preoperative factors such as sex, age, marital status, country of birth, use of an interpreter, any children, type of residence, use of community services, American Society of Anaesthesiology (ASA) score, and whether the patient lives on their own, is a sole carer or requires help with activities of daily living were recorded.

Overall median age was 66 years (58–75 years). Median post-operative LOS for patients not delayed in discharge was 8 days and 15 days for patients with an identifiable non-medical reason for delay (P < 0.0001). Preoperative factors significantly associated with a delay included advanced age (odds ratio (OR): 10.5; 95% confidence interval (CI): 3.0–37.7; P < 0.0001), being widowed (OR: 3.5; 95% CI: 1.2–10.2; P = 0.02) and living in a retirement village (OR 15.4; 95% CI: 1.6–150.3; P = 0.019). Higher ASA scores strongly correlated with longer LOS.

This study confirms that preoperative factors are important in contributing to non-medical delays in discharge and longer post-operative LOS after elective colorectal resections.