Ileostomy Patients Using Patient Engagement Technology Experience Decreased Length of Stay

被引:10
作者
Smithson, Mary [1 ]
McLeod, M. Chandler [1 ]
Theiss, Lauren [1 ]
Shao, Connie [1 ]
Kennedy, Gregory [1 ]
Hollis, Robert [1 ]
Chu, Daniel I. [1 ]
Hardiman, Karin M. [1 ]
机构
[1] Univ Alabama Birmingham, Dept Surg, KB 428,1922 7th Ave South, Birmingham, AL 35294 USA
关键词
Surgical research; Ileostomy outcomes; Seamless; Patient engagement technology; ENHANCED RECOVERY; STOMA EDUCATION; READMISSIONS; SURGERY; ANALGESIA; COLECTOMY; PROGRAM; PATHWAY;
D O I
10.1007/s11605-021-05158-z
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Patients who undergo colorectal surgery, particularly, construction of a new ileostomy, are known to have longer length of stay (LOS) and increased readmissions. With the increased availability of patient engagement technology (PET), we hypothesized that because PET facilitates education before and after surgery, ileostomy patients who used PET would have decreased LOS without increasing readmissions. Variables were obtained from the National Surgical Quality Improvement Program (NSQIP) database for patients undergoing ileostomy construction. Study patients were categorized into three groups: pre-PET (patients prior to PET), non-PET (patients who did not use PET), and PET users (patients who used PET). Univariate analysis of patient and surgical characteristics, LOS, ED visits, and readmissions and multivariable modeling of potential predictors of LOS were performed. There were 106 patients in the pre-PET, 51 in the PET, and 108 in the non-PET and cohorts were similar except pre-op diagnosis. Length of stay was lower for the PET cohort (p = 0.0001), with no significant difference in readmission or ED visits. On multivariable analysis, we identified the PET cohort as an independent predictor of shorter LOS relative to non-PET and pre-PET (p = 0.007 and p = 0.02, respectively). Similarly, patients had significantly shorter LOS who had a diagnosis of neoplasm as compared to IBD (p = 0.03). Hypertension requiring medication (p = 0.001) and Black race relative to White race (p = 0.002) were independent predictors of longer LOS. In this study of ileostomy patients, we have shown that use of PET is an independent predictor of decreased LOS without increased ED visits or readmissions.
引用
收藏
页码:635 / 642
页数:8
相关论文
共 25 条
[1]   Sources of information used by patients prior to elective surgery: a scoping review [J].
Atlas, Alvin ;
Milanese, Steve ;
Grimmer, Karen ;
Barras, Sarah ;
Stephens, Jacqueline H. .
BMJ OPEN, 2019, 9 (08)
[2]   RECOVERY AFTER LAPAROSCOPIC COLONIC SURGERY WITH EPIDURAL ANALGESIA, AND EARLY ORAL NUTRITION AND MOBILIZATION [J].
BARDRAM, L ;
FUNCHJENSEN, P ;
JENSEN, P ;
CRAWFORD, ME ;
KEHLET, H .
LANCET, 1995, 345 (8952) :763-764
[3]   Preoperative intensive, community-based vs. traditional stoma education:: A randomized, controlled trial [J].
Chaudhri, S ;
Brown, L ;
Hassan, I ;
Horgan, AF .
DISEASES OF THE COLON & RECTUM, 2005, 48 (03) :504-509
[4]   'Fast track' postoperative management protocol for patients with high co-morbidity undergoing complex abdominal and pelvic colorectal surgery [J].
Delaney, CP ;
Fazio, VW ;
Senagore, AJ ;
Robinson, B ;
Halverson, AL ;
Remzi, FH .
BRITISH JOURNAL OF SURGERY, 2001, 88 (11) :1533-1538
[5]   Pre- and postoperative stoma education and guidance within an enhanced recovery after surgery (ERAS) programme reduces length of hospital stay in colorectal surgery [J].
Forsmo, H. M. ;
Pfeffer, F. ;
Rasdal, A. ;
Sintonen, H. ;
Koerner, H. ;
Erichsen, C. .
INTERNATIONAL JOURNAL OF SURGERY, 2016, 36 :121-126
[6]   WOCN Society Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary OstomyAn Executive Summary [J].
Goldberg, Margaret ;
Colwell, Janice ;
Burns, Susan ;
Carmel, Jane ;
Fellows, Jane ;
Hendren, Samantha ;
Livingston, Vashti ;
Nottingham, Charles U. ;
Pittman, Joyce ;
Rafferty, Janice ;
Salvadalena, Ginger ;
Steinberg, Gary ;
Palmer, Ronald ;
Bonham, Phyllis .
JOURNAL OF WOUND OSTOMY AND CONTINENCE NURSING, 2018, 45 (01) :50-58
[7]   Patient autonomy-centered self-care checklist reduces hospital readmissions after ileostomy creation [J].
Hardiman, Karin M. ;
Reames, Christina D. ;
McLeod, Marshall C. ;
Regenbogen, Scott E. .
SURGERY, 2016, 160 (05) :1302-1308
[8]   Does Diverting Loop Ileostomy Improve Outcomes Following Open Ileo-Colic Anastomoses? A Nationwide Analysis [J].
Hawkins, Alexander T. ;
Dharmarajan, Sekhar ;
Wells, Katerina K. ;
Krishnamurty, Devi Mukkai ;
Mutch, Matthew G. ;
Glasgow, Sean C. .
JOURNAL OF GASTROINTESTINAL SURGERY, 2016, 20 (10) :1738-1743
[9]   Readmissions After Colectomy: The Upstate New York Surgical Quality Initiative Experience [J].
Hensley, Bradley J. ;
Cooney, Robert N. ;
Hellenthal, Nicholas J. ;
Aquina, Christopher T. ;
Noyes, Katia ;
Monson, John R. ;
Kelly, Kristin N. ;
Fleming, Fergal J. .
DISEASES OF THE COLON & RECTUM, 2016, 59 (05) :419-425
[10]   Readmissions With Dehydration After Ileostomy Creation: Rethinking Risk Factors [J].
Justiniano, Carla F. ;
Temple, Larissa K. ;
Swanger, Alex A. ;
Xu, Zhaomin ;
Speranza, Jenny R. ;
Cellini, Christina ;
Salloum, Rabih M. ;
Fleming, Fergal J. .
DISEASES OF THE COLON & RECTUM, 2018, 61 (11) :1297-1305