Safety of hospital discharge before return of bowel function after elective colorectal surgery

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dc.contributor.authorChapman, S.J.
dc.contributor.authorBlanco-Colino, R.
dc.contributor.authorPérez-Ajates, S.
dc.contributor.authorBautista, O.A.
dc.contributor.authorHodson, J.
dc.contributor.authorBlanco-Colino, R.
dc.contributor.authorChapman, S.J.
dc.contributor.authorGlasbey, J.C.
dc.contributor.authorPata, F.
dc.contributor.authorPellino, G.
dc.contributor.authorSoares, A.S.A.
dc.contributor.authorvan Elst, T.
dc.contributor.authorVan Straten, S.
dc.contributor.authorNepogodiev, D.
dc.contributor.authorHodson, J.
dc.contributor.authorBorakati, A.
dc.contributor.authorBath, M.F.
dc.contributor.authorYasin, I.H.
dc.contributor.authorMclean, K.
dc.contributor.authorArthur, T.
dc.contributor.authoret al.
dc.date.issued2020
dc.description.abstractBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9⋅2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P <0⋅001). There were no significant differences in rates of readmission between these groups (6⋅6 versus 8⋅0 per cent; P =0⋅499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0⋅90, 95 per cent c.i. 0⋅55 to 1⋅46; P =0⋅659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34⋅7 versus 39⋅5 per cent; major 3⋅3 versus 3⋅4 per cent; P =0⋅110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.
dc.description.statementofresponsibilityEuroSurg Collaborative
dc.identifier.citationBritish Journal of Surgery, 2020; 107(5):552-559
dc.identifier.doi10.1002/bjs.11422
dc.identifier.issn0007-1323
dc.identifier.issn1365-2168
dc.identifier.urihttps://hdl.handle.net/2440/146561
dc.language.isoen
dc.publisherOxford University Press
dc.rights© 2020 BJS Society Ltd. Published by John Wiley & Sons Ltd
dc.source.urihttps://doi.org/10.1002/bjs.11422
dc.subjectdefecation; postoperative complications; colorectal surgery; intestines; patient discharge; patient readmission; safety; surgical procedures; operative; colorectal resection; ileus; general surgery; lower gastrointestinal surgery
dc.subject.meshHumans
dc.subject.meshIleus
dc.subject.meshPostoperative Complications
dc.subject.meshPatient Discharge
dc.subject.meshPatient Readmission
dc.subject.meshColectomy
dc.subject.meshColostomy
dc.subject.meshIleostomy
dc.subject.meshMultivariate Analysis
dc.subject.meshFollow-Up Studies
dc.subject.meshProspective Studies
dc.subject.meshRecovery of Function
dc.subject.meshAdult
dc.subject.meshMiddle Aged
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshPatient Safety
dc.subject.meshElective Surgical Procedures
dc.subject.meshProctectomy
dc.titleSafety of hospital discharge before return of bowel function after elective colorectal surgery
dc.typeJournal article
pubs.publication-statusPublished

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