Photo Credit: BOTCookie
A study of 3,008 patients with IBD revealed that factors like rectal surgery, new ileostomy, preoperative hospitalization, and specific health conditions contribute significantly to a longer post-surgery stay, with those admitted before surgery and undergoing rectal procedures at the highest risk.
The following is a summary of “Impact of Preoperative Factors in Patients With IBD on Postoperative Length of Stay: A National Surgical Quality Improvement Program–Inflammatory Bowel Disease Collaborative Analysis,” published in the January 2024 issue of Gastroenterology by Hill, et al.
It is hard to take care of patients with IBD before surgery because the disease is complicated, and they have other health problems at the same time. For a study, researchers sought to determine if preoperative factors and operation type were linked to a longer length of stay after surgery for IBD, described as being in the 75th percentile or higher (n = 926; 30.8%). It was a cross-sectional study that used a multicenter database to examine past data.
The National Surgery Quality Improvement Program–Inflammatory Bowel Disease Collaborative got information from 15 places with a lot of surgeries. Patients: From March 2017 to February 2020, there were 3008 people with IBD; 1,710 had Crohn’s disease and 1,291 had ulcerative colitis. The average length of stay after surgery was 4 days, with a range of 3 to 7 days. Using multivariable logistic regression, they found that multiple clinical and demographic factors were linked to a higher chance of a longer length of stay after surgery (model P < 0.001, area under receiver operating characteristic curve = 0.85).
It was clinically significant that rectal surgery (vs. colon; OR, 2.13; 95% CI, 1.52–2.98), new ileostomy (vs. no ileostomy; OR, 1.50; 95% CI, 1.15–1.97), being hospitalized before surgery (OR, 13.45; 95% CI, 10.15–17.84), not being able to go home (OR, 4.78; 95% CI, 2.27–10.08), low albuminemia (OR, 1.66; 95% CI, 1.27–2.18), and bleeding disorder (OR, 2.42; 95% CI, 1.22–4.82). Patients with IBD who were admitted before surgery were not sent home and had rectal surgery had the highest risk of a longer length of stay after surgery. Patients with a blood problem, low albumin levels, or ASA classes 3 to 5 were more likely to be affected. On multivariate analysis, long-term use of corticosteroids, immune drugs, small molecules, and biological agents had no effect.
