An HDU stay of ≤ 48 hours was associated with a higher proportion of post-operative complications compared to a stay > 48 hours (72.2% vs 27.8%, p=0.04).
Cohort (n=40)
Does early discharge (≤ 48 hours) from the High Dependency Unit increase post-operative complications and length of stay in high-risk elective colorectal patients?
Early discharge (≤ 48 hours) from the High Dependency Unit for high-risk elective colorectal patients is associated with increased post-operative complications, higher readmission rates, and prolonged total length of stay.
Absolute Event Rate: 72.2% vs 27.8%
p-value: p=0.04
Background: Despite recent advances,high-risk patients undergoing elective colorectal surgery still have significant morbidity and mortality. For patients electively admitted to level II care, premature discharge can contribute to poor outcomes. Objectives: The main objectives were to review the level II care provided to high-risk elective colorectal patients with regards to their timing of discharge from the HDU and rate of post-operative complications, re-admissions, total length of stay (LOS) and mortality Methods: All elective colorectal patients admitted to HDU during 2010 were included. Patients were divided into two groups with regards to their stay on HDU: Group1 ≤ 48 hrs and Group2 >48 hrs. Data regarding demographics, post-operative complications, LOS, re-admission to HDU and mortality were collected and analysed using SPSS version 14. Results: Out of the total of 40 patients, 24 (60%) were females; the median age was 74 (IQR 45-92) years. Laparoscopic procedures were performed in 31 (77.5%) patients. There were 26 patients in Group 1 and 14 in Group 2. Post-operative complications were higher (72.2% Vs 27.8%, p-value=0.04), and the LOS was significantly longer amongst Group 1 patients [8 (IQR 4-41) Vs 6.5(IQR4-12) days, p-value 0.03). Four patients in Group 1 were readmitted to HDU compared to none in Group 2. No mortality was observed. Conclusion: Early discharge from the HDU is associated with significant risk of complications, HDU re-admission (10%) and prolonged LOS. Ensuring a minimum HDU stay of 48 hrs could reduce post-operative morbidity, thus optimizing HDU patient care.
Siddique et al. (Sun,) conducted a cohort in Elective colorectal surgery (n=40). HDU stay ≤ 48 hours vs. HDU stay > 48 hours was evaluated on Post-operative complications (p=0.04). An HDU stay of ≤ 48 hours was associated with a higher proportion of post-operative complications compared to a stay > 48 hours (72.2% vs 27.8%, p=0.04).