| Title |
The impact of complications after elective colorectal resection within an enhanced recovery pathway
|
|---|---|
| Published in |
Techniques in Coloproctology, March 2018
|
| DOI | 10.1007/s10151-018-1761-x |
| Pubmed ID | |
| Authors |
L. Lee, S. Liberman, P. Charlebois, B. Stein, P. Kaneva, F. Carli, L. S. Feldman |
| Abstract |
Despite the implementation of enhanced recovery pathways (ERP), morbidity following colorectal surgery remains high. The aim of the present study was to estimate the impact of postoperative complications on excess hospital length of stay (LOS) in patients undergoing elective colorectal resection. A retrospective study of patients undergoing elective colorectal surgery at a single institution from 2003 to 2010 was performed. Patients managed by an ERP were compared to conventional care (CC), matched by propensity score radius matching. Complications were defined a priori. Excess (independent effect on LOS from multivariate analysis) and attributable (absolute number of additional bed days) LOS of common postoperative complications determined the impact of complications on bed utilization. Multivariate analysis was performed using multiple linear regression. A total of 810 propensity-score-matched patients were included (ERP = 472, CC = 338). Complications were significantly lower in the ERP group compared to the CC group (20 vs. 31%, p < 0.001). Median LOS decreased from 7 days in the CC group to 5 days in the ERP group [adjusted decrease in mean LOS of 2.8 days (95% CI 0.8, 4.8)]. Anastomotic leak, myocardial infarction and C. difficile infection had the highest excess LOS for both the ERP and CC groups. However, impaired gastrointestinal function had a higher impact on the absolute number of hospital bed days in the ERP group, as high as anastomotic leak (72.7 vs. 73.5 days respectively), while in the CC group the impact of gastrointestinal dysfunction was less of that of anastomotic leak (50.6 vs. 78.9 days respectively). In the setting of an ERP, postoperative complications have significant impact on total bed utilization. Impaired gastrointestinal function, given its high incidence, accounted for almost the same number of additional hospital bed days as anastomotic leak in the ERP group and is a target for quality improvement. |
X Demographics
The data shown below were collected from the profiles of 24 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 5 | 21% |
| Australia | 3 | 13% |
| Chile | 2 | 8% |
| India | 1 | 4% |
| Ecuador | 1 | 4% |
| Mexico | 1 | 4% |
| Italy | 1 | 4% |
| United States | 1 | 4% |
| Spain | 1 | 4% |
| Other | 0 | 0% |
| Unknown | 8 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 10 | 42% |
| Members of the public | 7 | 29% |
| Science communicators (journalists, bloggers, editors) | 5 | 21% |
| Scientists | 2 | 8% |
Mendeley readers
The data shown below were compiled from readership statistics for 24 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 24 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 5 | 21% |
| Other | 2 | 8% |
| Student > Doctoral Student | 2 | 8% |
| Student > Master | 2 | 8% |
| Student > Postgraduate | 2 | 8% |
| Other | 4 | 17% |
| Unknown | 7 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 13 | 54% |
| Nursing and Health Professions | 2 | 8% |
| Materials Science | 1 | 4% |
| Unspecified | 1 | 4% |
| Unknown | 7 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 May 2018.
All research outputs
#2,665,472
of 24,615,949 outputs
Outputs from Techniques in Coloproctology
#278
of 1,333 outputs
Outputs of similar age
#55,322
of 336,846 outputs
Outputs of similar age from Techniques in Coloproctology
#15
of 24 outputs
Altmetric has tracked 24,615,949 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,333 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.6. This one has done well, scoring higher than 79% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 336,846 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 83% of its contemporaries.
We're also able to compare this research output to 24 others from the same source and published within six weeks on either side of this one. This one is in the 41st percentile – i.e., 41% of its contemporaries scored the same or lower than it.