Predictors of postdischarge complications: role of in-hospital length of stay

BACKGROUND: Surgical length of stay (LOS) has been correlated with quality of care, with shorter stays implying better care. The relationship between LOS and postdischarge complications (PDCs) has not been evaluated effectively. METHODS: The 2005 to 2007 National Surgical Quality Improvement Program data were queried for patients undergoing elective colectomies. The outcome of interest was the development of a PDC. Multivariate analysis was then performed adjusting for demographics, surgical approach, and comorbidities. RESULTS: A total of 12,956 colectomies were analyzed with an overall PDC of 8.7%. LOS was not associated with increased odds of developing a PDC. The laparoscopic approach reduced the risk of PDCs by 30% (odds ratio = .70, 95% confidence interval, 0.61-0.81). Body mass index, female sex, the presence of diabetes mellitus, and prolonged operative time increased the odds of developing a PDC. CONCLUSIONS: A shorter LOS did not correlate with a reduction in the likelihood of PDCs. Further investigation into the role of LOS as a measure of quality care is needed. (C) 2013 Elsevier Inc. All rights reserved.