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Predicting Days at Home after Elective Surgery for Gastrointestinal Cancer using HOMEDAYS: Prediction Model

Tiago Ribeiro^1,2, Adom Bondzi-Simpson^1,2, Wing C Chan³

¹. Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

Journal of the American College of Surgeons

|May 1, 2026

Summary

A new tool, HOMEDAYS, accurately predicts days at home after gastrointestinal cancer surgery. This patient-centered outcome helps improve surgical counseling and decision-making.

Keywords:

Days at home gastrointestinal cancer patient-centered prediction tool

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Area of Science:

Oncology
Surgical Outcomes Research
Health Services Research

Background:

Traditional metrics inadequately capture patient-centered outcomes post-gastrointestinal cancer surgery, hindering preoperative counseling.
Days at home within 90 days after surgery (DAH-90) is a valuable metric but lacks a predictive tool.

Purpose of the Study:

To develop and validate a prediction model (HOMEDAYS) for estimating median DAH-90 in patients undergoing elective gastrointestinal cancer surgery.

Main Methods:

A multivariable prediction model was developed using quantile regression on population-based administrative data from Ontario, Canada (2003-2021).
Model performance was evaluated using mean absolute error, calibration, and discrimination, with internal validation via bootstrap resampling.

Main Results:

The HOMEDAYS model, incorporating 23 predictors, demonstrated strong accuracy (MAE 8.67) and good calibration and discrimination.
Optimism-corrected metrics confirmed model stability, with minimal deviation between predicted and observed DAH-90 across deciles.
Model performance was robust across sensitivity analyses, including alternative outcome definitions.

Conclusions:

The internally validated HOMEDAYS model accurately predicts DAH-90 using preoperative variables.
This tool facilitates individualized, patient-centered risk communication for gastrointestinal cancer surgery.
HOMEDAYS can enhance shared decision-making and perioperative preparedness.