Length of stay after colorectal surgery in Italy: the gap between “fit for” and “actual” discharge in a prospective cohort of 4529 cases
Abstract Background It is common to observe a gap between the day on which the discharge criteria are reached and the actual day of discharge after colorectal surgery. The aim of this study is to understand the reasons for this difference and its clinical impact on the overall length of stay (LOS)....
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BMC
2025-02-01
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| Series: | Perioperative Medicine |
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| Online Access: | https://doi.org/10.1186/s13741-025-00492-1 |
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| author | Lorenzo Pandolfini Duccio Conti Piercarlo Ballo Silvia Rollo Alessandro Falsetto Gian Matteo Paroli Paolo Ciano Michele Benedetti Leonardo Antonio Montemurro Giacomo Ruffo Massimo Giuseppe Viola Felice Borghi Gianandrea Baldazzi Massimo Basti Pierluigi Marini Mariano Fortunato Armellino Vincenzo Bottino Giovanni Ciaccio Alessandro Carrara Gianluca Guercioni Marco Scatizzi Marco Catarci the Italian ColoRectal Anastomotic Leakage (iCral) study group |
| author_facet | Lorenzo Pandolfini Duccio Conti Piercarlo Ballo Silvia Rollo Alessandro Falsetto Gian Matteo Paroli Paolo Ciano Michele Benedetti Leonardo Antonio Montemurro Giacomo Ruffo Massimo Giuseppe Viola Felice Borghi Gianandrea Baldazzi Massimo Basti Pierluigi Marini Mariano Fortunato Armellino Vincenzo Bottino Giovanni Ciaccio Alessandro Carrara Gianluca Guercioni Marco Scatizzi Marco Catarci the Italian ColoRectal Anastomotic Leakage (iCral) study group |
| author_sort | Lorenzo Pandolfini |
| collection | DOAJ |
| description | Abstract Background It is common to observe a gap between the day on which the discharge criteria are reached and the actual day of discharge after colorectal surgery. The aim of this study is to understand the reasons for this difference and its clinical impact on the overall length of stay (LOS). Methods All patients enrolled in the prospective iCral3 study were analyzed regarding any difference and reason between the “fit for discharge” (FFD) and “actual discharge” (AD) dates. The association between the gap and the LOS in the whole population was then assessed through a multivariate regression model including other confounding variables. Results The analysis included 4529 patients, with a median [IQR] LOS of 6 [4–8] days. The median [IQR] LOS was 6 [4–8] days in the no-gap group (3,910 patients, 86.3%), significantly lower (p < .001) than 7 [6–10] days in the gap group (619 patients, 13.7%). Among the gap reasons, the “need for postoperative rehabilitation” compared to “not willing to return home” and “social constraints” was associated with the longest LOS (9 [6.0–12.5] days, p < 0.001 vs other reasons). The existence of the gap independently determined a 2.3-day lengthening of LOS. Conclusions Among other factors, the gap between FFD and AD had an independent impact on LOS. The most frequent reasons for this gap were “not willing to return home” and “social constraint”, while the “need for postoperative rehabilitation” had the greater clinical impact. |
| format | Article |
| id | doaj-art-a2bd75ecaf214af3848cd7eac27ba51a |
| institution | Kabale University |
| issn | 2047-0525 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Perioperative Medicine |
| spelling | doaj-art-a2bd75ecaf214af3848cd7eac27ba51a2025-02-09T12:47:53ZengBMCPerioperative Medicine2047-05252025-02-011411910.1186/s13741-025-00492-1Length of stay after colorectal surgery in Italy: the gap between “fit for” and “actual” discharge in a prospective cohort of 4529 casesLorenzo Pandolfini0Duccio Conti1Piercarlo Ballo2Silvia Rollo3Alessandro Falsetto4Gian Matteo Paroli5Paolo Ciano6Michele Benedetti7Leonardo Antonio Montemurro8Giacomo Ruffo9Massimo Giuseppe Viola10Felice Borghi11Gianandrea Baldazzi12Massimo Basti13Pierluigi Marini14Mariano Fortunato Armellino15Vincenzo Bottino16Giovanni Ciaccio17Alessandro Carrara18Gianluca Guercioni19Marco Scatizzi20Marco Catarci21the Italian ColoRectal Anastomotic Leakage (iCral) study groupGeneral Surgery Unit, Santa Maria Annunziata & Serristori Hospital, ASL Toscana CentroAnesthesiology Unit, Santa Maria Annunziata & Serristori Hospital, ASL Toscana CentroCardiology Unit, Santa Maria Annunziata & Serristori Hospital, ASL Toscana CentroGeneral Surgery Unit, Santa Maria Annunziata & Serristori Hospital, ASL Toscana CentroGeneral Surgery Unit, Santa Maria Annunziata & Serristori Hospital, ASL Toscana CentroGeneral Surgery Unit, Santa Maria Annunziata & Serristori Hospital, ASL Toscana CentroGeneral Surgery Unit, Sandro Pertini HospitalGeneral Surgery Unit, Sandro Pertini HospitalGeneral Surgery Unit, Sandro Pertini HospitalGeneral Surgery Unit, IRCCS Sacro Cuore Don Calabria HospitalGeneral Surgery Unit, Cardinale G. Panico HospitalOncologic Surgery Unit, Candiolo Cancer Institute, FPO-IRCCSGeneral Surgery Unit, ASST Ovest Milanese, Nuovo Ospedale Di LegnanoGeneral Surgery Unit, Spirito Santo HospitalGeneral & Emergency Surgery Unit, San Camillo-Forlanini HospitalGeneral & Emergency Surgery Unit, S. Giovanni Di Dio E Ruggi d’Aragona HospitalGeneral & Oncologic Surgery Unit, Evangelico Betania HospitalGeneral Surgery Unit, S. Elia Hospital1St General Surgery Unit, S. Chiara HospitalGeneral Surgery Unit, “C. E G. Mazzoni” HospitalGeneral Surgery Unit, Santa Maria Annunziata & Serristori Hospital, ASL Toscana CentroGeneral Surgery Unit, Sandro Pertini HospitalAbstract Background It is common to observe a gap between the day on which the discharge criteria are reached and the actual day of discharge after colorectal surgery. The aim of this study is to understand the reasons for this difference and its clinical impact on the overall length of stay (LOS). Methods All patients enrolled in the prospective iCral3 study were analyzed regarding any difference and reason between the “fit for discharge” (FFD) and “actual discharge” (AD) dates. The association between the gap and the LOS in the whole population was then assessed through a multivariate regression model including other confounding variables. Results The analysis included 4529 patients, with a median [IQR] LOS of 6 [4–8] days. The median [IQR] LOS was 6 [4–8] days in the no-gap group (3,910 patients, 86.3%), significantly lower (p < .001) than 7 [6–10] days in the gap group (619 patients, 13.7%). Among the gap reasons, the “need for postoperative rehabilitation” compared to “not willing to return home” and “social constraints” was associated with the longest LOS (9 [6.0–12.5] days, p < 0.001 vs other reasons). The existence of the gap independently determined a 2.3-day lengthening of LOS. Conclusions Among other factors, the gap between FFD and AD had an independent impact on LOS. The most frequent reasons for this gap were “not willing to return home” and “social constraint”, while the “need for postoperative rehabilitation” had the greater clinical impact.https://doi.org/10.1186/s13741-025-00492-1Colorectal surgeryERASLength of stayFit for dischargeActual discharge |
| spellingShingle | Lorenzo Pandolfini Duccio Conti Piercarlo Ballo Silvia Rollo Alessandro Falsetto Gian Matteo Paroli Paolo Ciano Michele Benedetti Leonardo Antonio Montemurro Giacomo Ruffo Massimo Giuseppe Viola Felice Borghi Gianandrea Baldazzi Massimo Basti Pierluigi Marini Mariano Fortunato Armellino Vincenzo Bottino Giovanni Ciaccio Alessandro Carrara Gianluca Guercioni Marco Scatizzi Marco Catarci the Italian ColoRectal Anastomotic Leakage (iCral) study group Length of stay after colorectal surgery in Italy: the gap between “fit for” and “actual” discharge in a prospective cohort of 4529 cases Perioperative Medicine Colorectal surgery ERAS Length of stay Fit for discharge Actual discharge |
| title | Length of stay after colorectal surgery in Italy: the gap between “fit for” and “actual” discharge in a prospective cohort of 4529 cases |
| title_full | Length of stay after colorectal surgery in Italy: the gap between “fit for” and “actual” discharge in a prospective cohort of 4529 cases |
| title_fullStr | Length of stay after colorectal surgery in Italy: the gap between “fit for” and “actual” discharge in a prospective cohort of 4529 cases |
| title_full_unstemmed | Length of stay after colorectal surgery in Italy: the gap between “fit for” and “actual” discharge in a prospective cohort of 4529 cases |
| title_short | Length of stay after colorectal surgery in Italy: the gap between “fit for” and “actual” discharge in a prospective cohort of 4529 cases |
| title_sort | length of stay after colorectal surgery in italy the gap between fit for and actual discharge in a prospective cohort of 4529 cases |
| topic | Colorectal surgery ERAS Length of stay Fit for discharge Actual discharge |
| url | https://doi.org/10.1186/s13741-025-00492-1 |
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