Risk factors for prolonged hospitalization in patients undergoing laparoscopic adrenalectomy.

Abstract

IntroductionEven though laparoscopic adrenalectomy is currently a standard, there are important variations between different centres in short-term treatment results such as length of hospital stay (LOS) or morbidity.AimTo determine the factors affecting LOS in patients after laparoscopic transperitoneal lateral adrenalectomy (LTA).Material and methodsThe study enrolled 453 patients (173 men and 280 women, mean age 57 years) who underwent LTA between 2009 and 2017. Discharge from hospital after more than median hospital stay was considered as prolonged LOS. We evaluated factors that potentially may influence LOS (primary length of stay after surgery, excluding readmissions). Logistic regression models were used in univariate and corrected multivariate analyses, in order to identify the factors related to prolonged LOS.ResultsThe median LOS after LTA in the studied group was 2 days. One hundred seventy-five (38.5%) patients required prolonged hospitalization. Univariate logistic regression showed that the following factors were related to prolonged LOS: presence of any comorbidity, cardiovascular disease, intraoperative complications, postoperative complications, day of the week of operation (surgery on Thursday or Friday), intraoperative blood loss, need for transfusion, hormonal activity, postoperative drainage, ASA (III–IV) and histological type – pheochromocytoma. Multivariate logistic regression showed that only complications (OR = 3.86; 95% CI: 1.84–8.04), day of the week of operation (Thursday or Friday) (OR = 4.85; 95% CI: 3.04–7.73), need for drainage (OR = 3.63; 95% CI: 1.55–8.52), and histological type – pheochromocytoma (OR = 2.48; 95% CI: 1.35–4.54) prolonged LOS.ConclusionsProlonged length of hospital stay following laparoscopic transperitoneal lateral adrenalectomy is strongly associated with the presence of postoperative complications, day of the week of operation (Thursday or Friday), need for drainage, and histological type – pheochromocytoma.

Should surgical drainage after lateral transperitoneal laparoscopic adrenalectomy be routine?—A retrospective comparative study

“…With respect to postoperative hospital stay, studies indicated that postoperative drainage also prolongs (24,35,36). Our results were in line with them.…”

Transperitoneal laparoscopic surgery in large adrenal masses.

“…In their series, they found that tumor size was not associated with longer operative times or hospital LOS [29]. Pisarska et al also found in their large series that the size of the tumor did not affect the LOS [30]. In our study mean operation time for lesions ≥ 6 cm was 177 min, which was significantly longer than for smaller lesions (p = 0.01).…”

Temporal trends, predictors of blood transfusion and in‐hospital outcomes among patients with severe burn injury in the United States—A national database‐based analysis

“…Secondary outcomes included discharge disposition, health resource utilization as measured by the hospital length of stay (LOS) and total hospitalization charges between patients with and without blood transfusion. Longer LOS was defined as a LOS greater than or equal to the median for LOS, within the hospitalization for burn injury 21,22 . We also examined the trend of blood transfusion in patients with severe burn as a descriptive outcome.…”

“…Longer LOS was defined as a LOS greater than or equal to the median for LOS, within the hospitalization for burn injury. 21,22 We also examined the trend of blood transfusion in patients with severe burn as a descriptive outcome.…”