Predicting length of stay for trauma and emergency general surgery patients.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
09 2020
Historique:
received: 02 11 2019
revised: 29 01 2020
accepted: 31 01 2020
pubmed: 23 2 2020
medline: 26 11 2020
entrez: 22 2 2020
Statut: ppublish

Résumé

Predicting length of stay (LOS) is difficult for trauma and emergency general surgery (TEGS) patients. Our aim was to determine the accuracy of LOS predictions by TEGS team members and the NSQIP Risk Calculator and the patient factors associated with inaccurate predictions. LOS for 200 TEGS patients were predicted. Full-model univariate and multivariable linear regressions were used to determine associations between patient characteristics and inaccurate predictions. There were 1,518 predictions of LOS. LOS predictions were rarely correct (TEGS team: 30.7% all patients, 35.6% surgical; NSQIP: 33.0% surgical). No individual group nor NSQIP was significantly better at predicting LOS. Inaccurate predictions were associated with female patients, longer LOS, trauma, frailty, higher comorbidity and injury severity scores, and lesser disposition. Both the TEGS team and NSQIP are poor at predicting LOS for TEGS patients. Further work helping to guide LOS predictions for TEGS patients is warranted.

Sections du résumé

BACKGROUND
Predicting length of stay (LOS) is difficult for trauma and emergency general surgery (TEGS) patients. Our aim was to determine the accuracy of LOS predictions by TEGS team members and the NSQIP Risk Calculator and the patient factors associated with inaccurate predictions.
METHODS
LOS for 200 TEGS patients were predicted. Full-model univariate and multivariable linear regressions were used to determine associations between patient characteristics and inaccurate predictions.
RESULTS
There were 1,518 predictions of LOS. LOS predictions were rarely correct (TEGS team: 30.7% all patients, 35.6% surgical; NSQIP: 33.0% surgical). No individual group nor NSQIP was significantly better at predicting LOS. Inaccurate predictions were associated with female patients, longer LOS, trauma, frailty, higher comorbidity and injury severity scores, and lesser disposition.
CONCLUSION
Both the TEGS team and NSQIP are poor at predicting LOS for TEGS patients. Further work helping to guide LOS predictions for TEGS patients is warranted.

Identifiants

pubmed: 32081410
pii: S0002-9610(20)30067-2
doi: 10.1016/j.amjsurg.2020.01.055
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

757-764

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest No author has a conflict of interest to report.

Auteurs

Benjamin Stocker (B)

Northwestern University Feinberg School of Medicine, United States. Electronic address: benjamin.stocker@northwestern.edu.

Hannah K Weiss (HK)

Northwestern University Feinberg School of Medicine, United States. Electronic address: hannah.weiss@northwestern.edu.

Noah Weingarten (N)

Cleveland Clinic, Department of General Surgery, United States. Electronic address: weingan@ccf.org.

Kathryn Engelhardt (K)

Medical University of South Carolina, Department of Surgery, United States. Electronic address: engelhar@musc.edu.

Milo Engoren (M)

University of Michigan Medical Center, Department of Anesthesiology, United States. Electronic address: engorenm@med.umich.edu.

Joseph Posluszny (J)

Northwestern University Feinberg School of Medicine, Department of Surgery, United States. Electronic address: joseph.posluszny@nm.org.

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