A. Suzo1, B. Needleman1, K. Perry1, S. Noria1 1Ohio State University Wexner Medical Center,General & GI Surgery/Surgery/Medicine,Columbus, OH, USA
Indroduction:
Methods for decreasing length of stay (LOS) in surgical patients typically involve analysis of intraoperative and/or postoperative care. This study aims to investigate the impact of surgery start time and floor admission time on hospital length of stay after Roux-en-Y gastric bypass and sleeve gastrectomy.
Methods:
All patients who underwent index laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) at The Ohio State University Wexner Medical Center during FY2014 were identified. Preoperative, intraoperative, hospital stay, and postoperative data (demographics, comorbid conditions, hospital progress timestamps, and complications) were obtained from the electronic medical record. Mann-Whitney tests were used to determine associations between incision time, and time to admission to the hospital floor, with hospital length of stay (LOS).
Results:
A total of 291 patients were identified and included in the analyses. Of these, 174 patients underwent SG while 117 underwent RYGB. Patients who had a first start case had a shorter hospital LOS versus those whose case was later in the day, however the numbers did not reach significance (2.0 vs 2.6; p = 0.092) and RYGB (2.8 vs 2.9; p = 0.653). Interestingly, patients admitted to the bariatric surgery unit from the post-anesthesia care unit (PACU) before 1:00 pm had significantly shorter LOS than those admitted after 1:00 pm for SG (1.7 vs 2.6; p = 0.0006), but not for RYGB (2.5 vs 3.0; p = 0.359). This trend persisted for admission from the PACU before 2:00 pm for SG (1.9 vs 2.6; p = 0.0235) versus RYGB (2.7 vs 3.0; p = 0.8723). However, when the analysis was extended to 3:00 pm, there was no significant difference in LOS for SG (2.0 vs 2.6; p = 0.2127) versus RYGB (2.6 vs 3.1; p = 0.3977).
Conclusion:
Early arrival to the hospital floor is associated with a significantly shorter hospital length of stay for patient undergoing SG. This suggests that strategic scheduling of common surgical procedures may be used to improve patient outcomes and decreasing LOS.