Association of robotic surgery with early discharge, readmission, and complications in elective colectomy: an analysis of NSQIP data from 2012 to 2021

Authors

Angela Ting-Wei Hsu, Sinai Hospital of Baltimore, Lifebridge Health, 2435 Belvedere Ave, Baltimore, MD, 2121, USA.
Mofi Zion, Sinai Hospital of Baltimore, Lifebridge Health, 2435 Belvedere Ave, Baltimore, MD, 2121, USA.
Jocelyn Powell, Sinai Hospital of Baltimore, Lifebridge Health, 2435 Belvedere Ave, Baltimore, MD, 2121, USA.
Christopher R. D'Adamo, Sinai Hospital of Baltimore, Lifebridge Health, 2435 Belvedere Ave, Baltimore, MD, 2121, USA.
Marcie Feinman, Sinai Hospital of Baltimore, Lifebridge Health, 2435 Belvedere Ave, Baltimore, MD, 2121, USA.
Jessica Felton, Sinai Hospital of Baltimore, Lifebridge Health, 2435 Belvedere Ave, Baltimore, MD, 2121, USA.
Joshua H. Wolf, Sinai Hospital of Baltimore, Lifebridge Health, 2435 Belvedere Ave, Baltimore, MD, 2121, USA. joswolf@lifebridgehealth.org.

Document Type

Journal Article

Publication Date

10-14-2024

Journal

Journal of robotic surgery

Volume

18

Issue

1

DOI

10.1007/s11701-024-02121-3

Keywords

ERAS; Early discharge; Elective colectomy; Robotic surgery

Abstract

Background Early discharge (ED) after colectomy has become a target outcome for multiple reasons, but the factors associated with ED are not well characterized. This study investigated the factors associated with ED and evaluated the impact of ED on overall outcome. Methods Data from ACS-NSQIP were used to identify patients who underwent non-emergent colectomy from 2012 to 2021. ED was defined as length of stay ≤ 2 days. Unpaired t-tests, chi-square tests and adjusted multivariate logistic regression modeling were used to estimate associated factors for ED. Bounceback readmission was defined as readmission within 7 days of discharge. Results In this cohort of 282,490 patients, 43,137 (15.3%) met the criteria for ED. Robotic colectomy (OR 14.35; 95% CI [13.63-15.12]) was more strongly associated with ED than any other patient characteristic, including laparoscopic colectomy (6.82 [6.51-7.14], ref open colectomy). ED vs. non-ED patients had lower rates of 30-day (5.84 vs. 10.37%, p < 0.01) and bounceback (3.56 vs. 5.75%, p < 0.01) readmissions, overall complications (5.65 vs. 18.63%, p < 0.01) and post-discharge complications (4.21 vs. 7.49%, p < 0.01). Conclusions Robotic surgery was the variable most strongly associated with ED, with greater odds of ED compared to both laparoscopic and open colectomy. Patients who had ED after robotic surgery had lower rates of complications and readmission compared to non-ED patients.

APA Citation

Hsu, Angela Ting-Wei; Zion, Mofi; Powell, Jocelyn; D'Adamo, Christopher R.; Feinman, Marcie; Felton, Jessica; and Wolf, Joshua H., "Association of robotic surgery with early discharge, readmission, and complications in elective colectomy: an analysis of NSQIP data from 2012 to 2021" (2024). GW Authored Works. Paper 5838.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5838

Department

Surgery