Risk Factors for Prolonged Length of Stay in Abdominoplasty

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Presentation transcript:

Risk Factors for Prolonged Length of Stay in Abdominoplasty Benjamin B. Massenburg, BA Paymon Sanati-Mehrizy, BA Eric M. Jablonka, MD Peter J. Taub, MD

Disclosures None of the authors have any disclosures relevant to the information presented here.

Introduction This study aims to identify specific independent risk factors for prolonged length of stay in abdominoplasty An extended hospital stay following abdominoplasty can exert a significant toll on the healthcare system and its resources

Case Selection

Methods Bivariate Analysis Multivariate Regression Analysis Outcomes: prolonged length of stay was defined as a stay greater than 4 days, or greater than the 75th percentile for patients undergoing abdominoplasty General Complications: pneumonia, postoperative reintubation, ventilatory support for greater than 48 hours, deep venous thrombosis, pulmonary embolism, renal insufficiency, progressive renal failure, urinary tract infection, stroke, coma, peripheral neurologic deficiency, cardiac arrest, myocardial infarction, bleeding requiring a transfusion, sepsis/septic shock, wound complication, or flap failure.

Methods Chi-square or Fisher exact tests were used to analyze categorical variables Student t-tests were used to analyze continuous variables Multivariate logistic regression models tested the association between these risk factors and the aforementioned adverse outcomes.

Results 8,759 patients who underwent an abdominoplasty Average length of hospital stay of 3.3 days

Results Multivariate regression analysis demonstrated that: age male gender obesity ASA class of 3 or greater smoking status non-plastic surgeons were independent risk factors for a prolonged length of stay. diabetes pre-operative wounds significant preoperative weight loss bleeding disorders prolonged operative times

Multivariate Regression Analysis Multivariate Adjusted Odds Ratio 95% CI Variables Lower Bound Upper Bound P Value Age 1.034 1.028 1.041 0.000 Male Gender 1.550 1.296 1.854 Race 1.055 0.940 1.185 0.374 Obese 1.522 1.310 1.769 ASA ≥3 2.230 1.917 2.595 Smoking 1.795 1.472 2.188 Non-Plastic Surgeons 4.252 3.643 4.963 Inpatient Status 19.083 13.944 26.116 Pre-Operative Comorbidities Diabetes 1.451 1.209 1.740 Hypertension 1.153 0.989 1.345 0.105 Wound/Wound Infection 4.057 2.971 5.540 Steroid Use 1.096 0.690 0.956 >10% Weight Loss 2.172 0.953 4.952 0.033 Bleeding Disorder 1.669 1.087 2.564 0.032 Operative Time First Quartile (Reference) --- Second Quartile 1.756 1.436 2.147 Third Quartile 2.653 2.183 3.225 Fourth Quartile 4.832 3.97 5.882 ASA Cardiac Pulm Wound ThromboCOMP WOUNDCOMP Return to OR

Discussion These risk factors for a prolonged length of stay can aid in pre- and post-operative allocation of resources in order to ensure cost-effective and high-quality delivery of care for patients undergoing abdominoplasty

Thank you!