Correlates of Length of Stay in Gynecologic Oncology Patients Undergoing Inpatient Surgery

Massad, L. Stewart; Vogler, George A.; Herzog, Thomas J.; Mutch, David G.

doi:10.1006/gyno.1993.1275

Cited by 23 publications

(15 citation statements)

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“…Study populations included patients with gastrointestinal cancer, gynecologic cancer, leukemia, or lymphoma and patients undergoing various cancer surgeries. Three studies used BMI only [12,26,27], 1 used serum albumin only [13], and 5 used a combination of both [21,22,23,24,25]. In the 3 studies using BMI as the nutritional assessment method, no relationship between BMI and LOS was demonstrated.…”

Section: Resultsmentioning

confidence: 99%

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Role of Nutritional Status in Predicting the Length of Stay in Cancer: A Systematic Review of the Epidemiological Literature

et al. 2011

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Background: Length of stay (LOS) has been used as a surrogate marker for patients’ well-being during hospital treatment. We systematically reviewed all pertinent literature on the role of nutritional status in predicting LOS in cancer. Methods: A systematic search of human studies published in English was conducted using the MEDLINE data base (all articles published as of December 2010). We searched using the terms ‘nutritional status’ and ‘nutritional assessment’ and ‘nutritional screening’ and ‘malnutrition’ in combination with the following terms: length of stay, length of hospital stay, duration of stay, and duration of hospitalization together with ‘cancer’ or ‘oncology’. Results: The MEDLINE search identified a total of 149 articles, of which only 21 met the selection criteria. Of the 21 studies, 10 studies investigated gastrointestinal cancer patients, 4 gynecological cancer, and 7 heterogeneous cancer. Eight studies used subjective global assessment (SGA) or patient-generated SGA (PG-SGA), 9 used serum albumin and/or BMI, and 4 used other methods of nutritional assessment. Conclusions: Validated nutritional tools such as SGA/PG-SGA are better predictors of LOS in gastrointestinal cancers requiring surgery than in nonsurgical gastrointestinal cancer patients. Correcting malnutrition may decrease the LOS and perhaps even lower the rate of hospital readmissions in this population.

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Section: Resultsmentioning

confidence: 99%

“…Of the 9 studies described herein, 6 were retrospective [13,21,22,23,24,25] while 3 were prospective [12,26,27]. The sample size ranged from a minimum of 84 [13] to a maximum of 2,258 [27].…”

Section: Resultsmentioning

confidence: 99%

Role of Nutritional Status in Predicting the Length of Stay in Cancer: A Systematic Review of the Epidemiological Literature

et al. 2011

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“…In patients requiring surgery, the clinical impact of malnutrition includes an increased risk of peri-operative complications (Terada et al, 1988;Burnett et al, 1993;Obermair et al, 2001), increased postoperative residual tumour after initial surgery (Obermair et al, 2001) and increased length of hospital stay (Massad et al, 1993). A significant proportion of patients with gynaecological malignancies seem to experience malnutrition (Orr et al, 1985a, b;Spirtos and Ballon, 1988;Santoso et al, 2000;Gadducci et al, 2001) and patients with advanced ovarian cancer are particularly at risk (Tunca, 1983;Dickerson et al, 1995).…”

Section: Introductionmentioning

confidence: 99%

“…Various nutritional parameters such as Prognostic Nutritional Indices (Santoso et al, 2000), serum albumin, total protein, transferrin (Spirtos and Ballon, 1988;Obermair et al, 2001), haemoglobin (Massad et al, 1993) and anthropometric measurements including weight (Spirtos and Ballon, 1988;Donato et al, 1992;Santoso et al, 2000) have been used to assess the nutritional status in gynaecological cancer patients. The subjective global assessment (SGA) is a validated nutrition assessment tool that is commonly used to assess nutritional status of patients with a number of different conditions (Baker et al, 1982;Detsky et al, 1987;Hirsch et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

Malnutrition among gynaecological cancer patients

et al. 2006

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Objective: To assess the nutritional status of patients with gynaecological cancer. Design: A prospective study assessing the nutritional status of gynaecological patients with suspected or proven gynaecological cancer. Setting: Queensland Centre for Gynaecological Cancer, Brisbane, Australia; a tertiary referral centre for gynaecological cancer. Subjects: One hundred forty-five patients with suspected or proven gynaecological cancer aged 20-91 years. Intervention: Scored patient-generated subjective global assessment (PG-SGA) and serum albumin before treatment. Results: One hundred and sixteen (80%) patients were categorized as PG-SGA class A, 29 (20%) patients were PG-SGA B and none of the patients were PG-SGA C. Ovarian cancer patients had significantly lower serum albumin levels (P ¼ 0.003) and higher PG-SGA scores (Po0.001) than patients with other types of cancer and benign conditions. Sixty-seven per cent of patients with ovarian cancer were classified as PG-SGA B. After adjusting for patient's age, body mass index and albumin level, ovarian cancer patients were 19 times more likely to be categorized as PG-SGA class B compared to patients with benign conditions (95% confidence interval: 3.03-129.8; P ¼ 0.002). Conclusion: Malnutrition in gynaecological cancer patients is a significant problem, especially among those patients diagnosed with ovarian cancer.

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“…This study has demonstrated that with experience, 1 in 3 patients undergoing a laparotomy for gynaecological surgery can be discharged on day 2 post surgery, without an increased morbidity or readmission rate [8,9].…”

Section: Discussionmentioning

confidence: 84%

Early discharge after major gynaecological surgery: advantages of fast track surgery

Carter

Philp²,

Arora³

2011

OJOG

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Introduction: Fast Track Surgery (FTS) programs have been adopted by many specialties with documented improved patient outcomes and reduced length of stay (LOS). Methods: We initiated a FTS program in January 2008 and present our experience up to and including November 2010 on patients whose LOS was 2 days. Results: During the study period 242 patients had a laparotomy performed. Overall 54 (22.3%) patients were discharged on day 2. In the first year of initiating our FTS program 10% were discharged on day 2, 25% in year 2 and 31% in year 3. Twenty-two patients (41%) had malignant pathology and of these, 16 (73%) had local or regional spread and 6 (27%) had distant spread. Forty patients (74%) had vertical midline incisions (VMI) performed. Surgery was classified as complex in 40 cases (74%) and 6 (11%) patients underwent staging lymph node dissection. Average patient BMI was 26.1 with 44% of patients considered overweight or obese. There were no intraoperative complications recorded. When compared to 188 patients whose LOS was greater than 2 days, the early discharge cohort were more likely to have benign pathology, more likely to be younger, to have a transverse incision, to have received COX II inhibitors, to have a lower net haemoglobin (Hb) change and to tolerate early oral feeding. Conclusions: Increased clinical experience with FTS enables over 31% patients undergoing laparotomy to be safely discharged on day 2 without an increase in the readmission rate or morbidity.

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Correlates of Length of Stay in Gynecologic Oncology Patients Undergoing Inpatient Surgery

Cited by 23 publications

References 0 publications

Role of Nutritional Status in Predicting the Length of Stay in Cancer: A Systematic Review of the Epidemiological Literature

Role of Nutritional Status in Predicting the Length of Stay in Cancer: A Systematic Review of the Epidemiological Literature

Malnutrition among gynaecological cancer patients

Early discharge after major gynaecological surgery: advantages of fast track surgery

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