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Risk Factors for Nonhome Discharge After Esophagectomy for Neoplastic Disease
Christopher A Heid1, Mitri K Khoury2, Micah A Thornton3
1Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
The Annals of Thoracic Surgery
|September 1, 2020
Summary
Comorbidity, preoperative functional status, urinary tract infection, and length of stay predict nonhome discharge after esophagectomy for cancer. Early identification aids discharge planning and reduces costs.
Area of Science:
- Surgical Oncology
- Health Services Research
Background:
- Esophagectomies are complex surgeries with significant physiological impacts.
- Postoperative care often requires discharge to a facility other than home.
Purpose of the Study:
- To identify factors predicting nonhome discharge in patients undergoing esophagectomy for cancer.
Main Methods:
- Utilized the 2016-2017 American College of Surgeons National Surgical Quality Improvement Program Esophagectomy database.
- Excluded patients with in-hospital mortality, emergent operations, or missing data.
- Performed multivariable analysis to determine predictors of nonhome discharge.
Main Results:
- 12.0% of 1007 patients had a nonhome discharge.
- Predictors included higher Modified Charlson comorbidity index, partially dependent preoperative functional status, and urinary tract infection.
- Increased length of stay was also significantly associated with nonhome discharge.
Conclusions:
- Identified key factors associated with nonhome discharge after esophagectomy.
- Early identification of at-risk patients is crucial for discharge planning.
- Proactive planning may reduce nonmedical delays and healthcare expenditures.
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