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July 22, 2021Annals of Surgery

Esophagectomy Complications Impact Long-term Survival

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Key result

Excessive length of stay after esophagectomy independently predicted higher overall mortality (OR 1.56; 95% CI 1.46-1.67), reducing median survival from 53.6 to 30.6 months (P<0.0001).

Why the study?

Complications after esophagectomy impact short-term survival, but the specific effect of prolonged length of stay on long-term survival is unclear.

Does excessive length of stay (as a surrogate for postoperative complications) reduce long-term survival in patients undergoing esophagectomy who survive at least 90 days?

Population

20,719 patients undergoing esophagectomy surviving at least 90 days postoperatively

Comparison

Excessive length of stay (highest quintile) vs non-excessive length of stay

Design

Retrospective database cohort study

Authors

SSSandeep SachidanandaLTLava TimsinaNNNiharika Namburi

Discussion

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Overview

Prolonged LOS may mark higher long-term mortality after esophagectomy; leaves open whether complications drive outcomes in prospective data.

Study Design

Type

Cohort (n=20,719)

Multicenter

Yes

Structured PICO

Does excessive length of stay (as a surrogate for postoperative complications) reduce long-term survival in patients undergoing esophagectomy who survive at least 90 days?

P
Population
20,719 patients who underwent esophagectomy and survived at least 90 days postoperatively, evaluated for the effect of excessive length of stay on long-term survival.
E
Exposure
Excessive length of stay (ELOS, highest quintile of LOS, median 26 days, range 18-168 days) as a surrogate for postoperative complications.
C
Comparator
Non-ELOS group (length of stay not in the highest quintile).
O
Outcome
Long-term survival (overall mortality).hard clinical

Main Result

Odds Ratio: 1.56 (95% CI 1.46–1.67)

p-value: p=< 0.0001

Excessive length of stay after esophagectomy, indicative of postoperative complications, is an independent predictor of reduced long-term survival even among patients who survive the initial 90-day postoperative period.

Cite This Study

Sachidananda et al. (2021) conducted a cohort in Esophagectomy (n=20,719). Excessive length of stay (ELOS) vs. Non-ELOS was evaluated on overall mortality (OR 1.56, 95% CI 1.46-1.67, p=< 0.0001). Excessive length of stay after esophagectomy independently predicted higher overall mortality (OR 1.56; 95% CI 1.46-1.67), reducing median survival from 53.6 to 30.6 months (P<0.0001).

synapsesocial.com/papers/6a6a587701245da06ecb23d0https://doi.org/10.1097/sla.0000000000005093
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