Impact of Postoperative Ileus on Hospital Length of Stay in Colectomy Surgery Patients

1Global Health Outcomes Assessment, Wyeth Research, Collegeville, PA
2Premier, Inc, Charlotte, NC

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 32

Background:

The incidence of postoperative Ileus (POI) varies by type of surgery and could have a significant impact on economic and humanistic outcomes. Limited data are available on the impact of POI on hospital length of stay in colectomy surgery patients. The main objective of this study was to assess the impact of POI on hospital length of stay in colectomy patients.

Methods:

A retrospective cohort study design was used. Adult patients with a principal procedure code for partial excision of large intestine (ICD‐9 codes: 45.71‐45.79) discharged between January 2004 and December 2004 were identified from Premier's Perspective Comparative Database, an inpatient records database from more than 500 hospitals in the United States. The colectomy patients were further classified for the presence of POI and by the presence of paralytic ileus (ICD‐9 code 560.1) and/or digestive system complications (ICD‐9 code 997.4) during the study period. Multivariate hierarchical regression analysis was performed with log‐transformed length of stay as the dependent variable. Patient demographics, mortality risk, disease severity, admission source, payment type, and hospital characteristics were used as covariates.

Results:

A total of 17,876 patients with a primary procedure code for colectomy were identified, of which 3115 patients (17.4%) had a secondary diagnosis of POI, including paralytic ileus (n = 2732; 15.3%) and digestive system complications (n = 1899, 10.6%), with significant overlap between the 2 (n = 1516, 8.5%). The majority of colectomy patients with POI were male (54.1%), white (70.9%), and in the 51‐ to 64‐year age group (51.1%). The crude average hospital length of stay was significantly higher (P < .001) in colectomy patients with POI (13.75 ± 13.33 days) than in patients without POI (8.85 ± 9.49 days). The presence of POI was found to significantly increase hospital length of stay (antilog b = 1.29, P < .0001) in the regression model. Sex (P < .01), severity level (P < .0001), and hospital size (P < .05) were other significant predictors of hospital length of stay.

Conclusions:

Postoperative ileus is associated with a significant increase in the hospital length of stay of colectomy patients. Prevention of POI in colectomy patients could potentially decrease hospital length of stay and reduce costs.

Author Disclosure:

S. Iyer, Wyeth Research, employment; W. Saunders, Premier, Inc., employment.

To cite this abstract:

Iyer S, Saunders W. Impact of Postoperative Ileus on Hospital Length of Stay in Colectomy Surgery Patients. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 32. Journal of Hospital Medicine. 2008; 3 (suppl 1). https://www.shmabstracts.com/abstract/impact-of-postoperative-ileus-on-hospital-length-of-stay-in-colectomy-surgery-patients/. Accessed May 26, 2019.

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