Complications Only Account for Some Variation in Hospital LOS
Much of variation in LOS after colorectal resection is not due to patient illness or complications
MONDAY, June 30, 2014 (HealthDay News) -- For patients undergoing colorectal resection, much of the variation in extended length of stay is not due to patient illness or complications, according to a study published online June 25 in JAMA Surgery.
Robert W. Krell, M.D., from the University of Michigan Health System in Ann Arbor, and colleagues conducted a retrospective cohort study to examine the impact of complications on the variance in hospitals' extended length of stay rates after colorectal resection. Data were included for 22,664 adults undergoing colorectal resections in 199 hospitals from the 2009 American College of Surgeons National Surgical Quality Improvement Program.
The researchers found that 42.8 percent of patients with extended length of stays did not have a documented inpatient complication. Wide variation was seen in the rates of risk-adjusted extended length of stay (14.5 to 35.3 percent) and risk-adjusted inpatient complication (12.1 to 28.5 percent), but the two were weakly correlated (Spearman P = 0.056). Hospitals' inpatient complication rates accounted for 52.0 percent of the variation in extended length of stay rates.
"Much of the variation in hospitals' risk-adjusted extended length of stay rates is not attributable to patient illness or complications and therefore most likely represents differences in practice style," the authors write.
Two authors disclosed financial ties to Blue Cross/Blue Shield of Michigan and ArborMetrix.