What is the clinical evidence from this study?

Study design: Cohort. Population: Colorectal surgery (n=1218). Intervention: Decreased length of stay over time vs. Earlier time periods. Primary outcome: Total length of stay (MD 3.1, p=0.001).

What does this research mean for the field?

A decrease in length of hospital stay following colorectal surgery does not adversely affect operative mortality, morbidity, discharge disposition, or 120-day readmission rates. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Assess whether reducing postoperative length of stay in colorectal surgery compromises clinical outcomes, including mortality, morbidity, discharge disposition, and readmission rates.

November 1, 1999Diseases of the Colon & Rectum

Usefulness of a state-legislated, comparative database to evaluate quality in colorectal surgery

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Key result

A ~3-day reduction in length of stay after colorectal surgery does not worsen mortality or readmissions.

MD 3.1
P=0.001
n=1,218

Why the study?

Does a decreased length of stay after colorectal surgery affect mortality, morbidity, disposition, and readmission rates?

Population

1,218 consecutive patients who underwent transabdominal colorectal surgery from July 1, 1990, to June 30…

Design

Cohort

Follow-up

120 days for readmission

Authors

TGTito F. GorskiUniversity of California, Riverside LRLester RosenCleveland Clinic Florida SLSusan LawrenceContinuum Dynamics (United States)

Discussion

Member takes

Implication

Shorter colorectal surgery stays appear safe in this cohort; leaves open whether accelerated discharge can be broadly adopted without randomized confirmation.

Key Points

Assess whether reducing postoperative length of stay in colorectal surgery compromises clinical outcomes, including mortality, morbidity, discharge disposition, and readmission rates.
Evaluated 1,218 consecutive patients undergoing transabdominal colorectal surgery between July 1, 1990, and June 30, 1997.
Classified clinical risk using a state-legislated severity rating system (Atlas Admission Severity Groups 0 to 4).
Monitored 120-day readmission rates in a consecutive subset of 678 patients from July 1993 to June 1997 using electronic medical records.
Total length of stay decreased significantly by 3.1 days, dropping from 12.9 to 9.8 days over seven years (P = 0.001).
Operative mortality was 1.4% (P = 0.655) and morbidity was 2.6% (P = 0.033), with discharge disposition to home remaining unchanged (P = 0.21).
Among 678 followed patients, 14.7% (100/678) were readmitted within 120 days of discharge, with no significant difference across years (P = 0.302).

Study Design

Type

Cohort (n=1,218)

Structured PICO

Does a decreased length of stay after colorectal surgery affect mortality, morbidity, disposition, and readmission rates?

Population

1,218 consecutive patients undergoing transabdominal colorectal surgery between 1990 and 1997, evaluated for length of stay and postoperative quality indicators.

Exposure

Transabdominal colorectal surgery with performance improvement to reduce length of stay

Outcome

Length of stay, mortality, morbidity, discharge disposition, and readmission rates within 120 dayssafety

Main Result

Mean Difference: 3.1

Absolute Event Rate: 9.8% vs 12.9%

p-value: p=0.001

Decreasing length of stay after colorectal surgery over a 7-year period did not adversely affect mortality, morbidity, disposition, or readmission rates.

Cite This Study

Gorski et al. (1999) conducted a cohort in Colorectal surgery (n=1,218). Decreased length of stay over time vs. Earlier time periods was evaluated on Total length of stay (MD 3.1, p=0.001). A decreased length of stay after colorectal surgery (reduction of 3.1 days over 7 years; P=0.001) did not adversely affect mortality, morbidity, disposition, or 120-day readmission rates.

synapsesocial.com/papers/6aa7a7ce9885271c4fd132b3 https://doi.org/10.1007/bf02235033

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Implication

Shorter colorectal surgery stays appear safe in this cohort; leaves open whether accelerated discharge can be broadly adopted without randomized confirmation.