Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12913-017-2817-8
Title: Factors associated with prolonged length of stay for elective hepatobiliary and neurosurgery patients: a retrospective medical record review
Authors: Lee, S.Y
Lee, S.-H
Tan, J.H.H
Foo, H.S.L
Phan, P.H 
Kow, A.W.C 
Lwin, S 
Seah, P.M.Y
Mordiffi, S.Z 
Keywords: adult
aged
biliary tract surgery
cross-sectional study
elective surgery
female
human
incidence
length of stay
liver resection
male
medical record
middle aged
neurosurgery
organization and management
preoperative care
retrospective study
risk factor
Singapore
standards
statistics and numerical data
total quality management
Adult
Aged
Biliary Tract Surgical Procedures
Cross-Sectional Studies
Elective Surgical Procedures
Female
Hepatectomy
Humans
Incidence
Length of Stay
Male
Medical Records
Middle Aged
Neurosurgical Procedures
Preoperative Care
Quality Improvement
Retrospective Studies
Risk Factors
Singapore
Issue Date: 2018
Citation: Lee, S.Y, Lee, S.-H, Tan, J.H.H, Foo, H.S.L, Phan, P.H, Kow, A.W.C, Lwin, S, Seah, P.M.Y, Mordiffi, S.Z (2018). Factors associated with prolonged length of stay for elective hepatobiliary and neurosurgery patients: a retrospective medical record review. BMC health services research 18 (1) : 5. ScholarBank@NUS Repository. https://doi.org/10.1186/s12913-017-2817-8
Rights: Attribution 4.0 International
Abstract: BACKGROUND: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries. Thus, with potentially increased numbers of elective HPB and NS, this study seeks to explore perioperative factors associated with prolonged LOS for these patients to improve safety and quality of practice.METHODS: A retrospective cross-sectional medical record review study from January 2014 to January 2015 was conducted at a 1250-bed tertiary academic hospital in Singapore. All elective HPB and NS patients over 18 years old were included in the study except day and emergency surgeries, resulting in 150 and 166 patients respectively. Prolonged LOS was defined as above median LOS based on the complexity of the surgical procedure. The predictor variables were preoperative, intraoperative, and postoperative factors. Student's t-test and stepwise logistic regression analyses were conducted to determine which factors were associated with prolonged LOS.RESULTS: Factors associated with prolonged LOS for the HPB sample were age and admission after 5 pm but for the NS sample, they were functional status, referral to occupational therapy, and the number of hospital-acquired infections.CONCLUSION: Our findings indicate that preoperative factors had the greatest association with prolonged LOS for HPB and NS elective surgeries even after adjusting for surgical complexity, suggesting that patient safety and quality of care may be improved with better pre-surgery patient preparation and admission practices.
Source Title: BMC health services research
URI: https://scholarbank.nus.edu.sg/handle/10635/181225
ISSN: 14726963
DOI: 10.1186/s12913-017-2817-8
Rights: Attribution 4.0 International
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