Long Time from Diagnosis to Surgery May Increase Postoperative Complication Rates in Elective CD Intestinal Resections: An Observational Study

Background. There is lack of data analyzing short-term postoperative complications and time from diagnosis to surgery in Crohn’s disease (CD). Aim. To compare complication rates after elective abdominal operations in CD patients with different durations of disease. Methods. Retrospective observational study with CD patients who submitted to elective intestinal resections. Patients were allocated in 2 groups according to time to surgery (TS) in less or more than 5 years. Short-term postoperative complications were analyzed and compared between the 2 groups, and binary logistic regression analysis was performed to check for significant variables. Results. 123 patients were finally included, 77 with TS > 5 years (62.6%) and 46 with TS < 5 years (37.4%). Patients with TS > 5 years had higher rates of overall surgical complications (p=0.011), reoperations (p=0.003), surgical site infections (p=0.014), anastomotic dehiscence (p=0.021), abdominal abscesses (p=0.021), and overall medical complications (p=0.019). On logistic regression, the single significant variable was the confection of stomas (OR: 3.203; 95% CI: 1.011–10.151; p=0.048). Conclusions. Patients with longer time to surgery showed a significant increase in overall medical and surgical postoperative early complications after elective intestinal resections.

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Proton radiotherapy for prostate cancer in the Medicare population: Patterns of care and comparison of early toxicity with IMRT.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.4651 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 4651-4651

Author(s):

James B. Yu ◽

Pamela R. Soulos ◽

Laura D. Cramer ◽

Kenneth B Roberts ◽

Jeph Herrin ◽

...

Keyword(s):

Prostate Cancer ◽

Logistic Regression ◽

Cancer Patients ◽

Post Treatment ◽

Complication Rates ◽

Proton Radiotherapy ◽

Short Term ◽

Significant Difference ◽

Patient Reported ◽

One Year

4651 Background: Proton radiotherapy (PRT) is a costly treatment used for prostate cancer despite little evidence supporting its use. We examined patterns of PRT use in the Medicare program and assessed the short-term toxicity of PRT vs. intensity modulated radiation therapy (IMRT). Methods: Using national Medicare claims from 2008-2009, we identified a sample of prostate cancer patients ages 66-94 who had received PRT or IMRT. We used multivariable logistic regression to identify patient and regional factors associated with receipt of PRT. We searched claims for procedure and diagnosis codes indicative of treatment-related complications and grouped the complications into genitourinary (GU), gastrointestinal (GI), and other complications. To compare the effect of PRT and IMRT on short-term toxicity, we used a Mahalanobis distance approach to match each PRT patient to two IMRT patients, achieving balanced distribution of clinical and sociodemographic characteristics. We compared six-month and one-year outcomes between the two treatment groups using conditional logistic regression. Results: We identified 27,647 men; 421 (2%) received PRT and 27,226 (98%) received IMRT. Patients who received PRT were widely geographically distributed, with some patients traveling >500 miles for treatment. PRT patients were younger, healthier, and of higher socioeconomic status. Although PRT was associated with a significant reduction in GU complications at six-months compared with IMRT (6.1% vs. 12.0%, OR 0.60 [95% CI 0.38-0.96], p=0.03), at one-year post-treatment there was no longer any difference in cumulative complication rates (18.9% vs. 21.9%, OR 0.96 [95% CI 0.61-1.53], p=0.88). There was no significant difference in GI or other complications at six-months or one-year post-treatment. Conclusions: Although PRT remains a scarcely used treatment, some prostate cancer patients traveled great distances for treatment. While PRT was associated with a reduction in six-month GU toxicity, there were no differences in toxicity at one-year. Further study on longer-term effects and other clinical and patient-reported outcomes is needed to inform the widespread application of PRT.

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Bipolar Transurethral Enucleation of the Prostate: Is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia?

PLoS ONE ◽

10.1371/journal.pone.0253083 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253083

Author(s):

Carolina Bebi ◽

Matteo Turetti ◽

Elena Lievore ◽

Francesco Ripa ◽

Lorenzo Rocchini ◽

...

Keyword(s):

Logistic Regression ◽

Postoperative Complications ◽

Prostate Volume ◽

Symptom Relief ◽

Urinary Flow ◽

Complication Rates ◽

Symptomatic Benign Prostatic Hyperplasia ◽

Sexual Symptoms ◽

First Choice

Background Bipolar Transurethral Enucleation of the Prostate (B-TUEP) is recommended as a first-choice treatment for benign prostatic obstruction in prostates >80 ml. Differently, B-TUEP is only considered as an alternative option after TURP for smaller prostates (30–80 ml). The aim of our study is to assess the relation between prostate size and surgical outcomes after B-TUEP. Methods We performed a retrospective analysis of data collected from 172 patients submitted to B-TUEP. Patients were segregated according to tertiles of prostate volume (PV) (≤60 ml, 61–110 ml, >110 ml). For each group we evaluated enucleation efficacy (enucleated weight/enucleation time), complication rates, urinary and sexual function parameters. Functional and sexual parameters were compared between groups at baseline, 1 and 3 months follow up. Descriptive statistics and linear and logistic regression models tested the association between PV and postoperative complications/outcomes. Results Operative time and weight of enucleated adenomas increased along with prostate volumes (all p≤0.01). Enucleation efficacy was higher in men with PV >110 ml compared to other groups (p≤0.001). Length of hospital stay, catheterization time and rates of postoperative complications, such as transfusion and clot evacuation rates and bladder neck/urethral strictures, were comparable between groups. Urinary symptoms improved at 1-and 3-months in each group as compared to baseline evaluation (all p<0.01) but they did not differ according to PV. In each group maximum urinary flow and post-void residual volume significantly improved at 3 months compared to baseline (all p≤0.01), without differences according to PV. Sexual symptoms were similar between groups at each follow up assessment. At multivariable linear and logistic regression analysis, prostate volume was not associated with postoperative functional outcomes and complications. Conversely, patient’s comorbid status and antiplatelet/anticoagulation use were independently associated with postoperative complications. Conclusion According to our findings, B-TUEP should be considered a “size independent procedure” as it can provide symptom relief in men with prostates of all sizes with the same efficacy and safety profile.

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Predictive Value of Matrix Metalloprotease 9 On Surgical Outcomes After Pericardiectomy

10.21203/rs.3.rs-659348/v1 ◽

2021 ◽

Author(s):

Likui Fang ◽

Wenfeng Yu ◽

Guocan Yu ◽

Bo Ye ◽

Gang Chen

Keyword(s):

Gene Expression ◽

Logistic Regression ◽

Regression Analysis ◽

Postoperative Complications ◽

Binary Logistic Regression ◽

Postoperative Outcomes ◽

Binary Logistic Regression Analysis ◽

Optimal Cutoff ◽

Cutoff Value ◽

High Level

Abstract Background The effects of matrix metalloproteases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) expressions on the patients with constrictive pericarditis undergoing pericardiectomy remain unclear. This study explored the associations of MMPs and TIMPs expressions with postoperative outcomes in these patients. Methods Pericardial specimens were obtained during pericardiectomy from the patients with constrictive pericarditis. The levels of MMP1, MMP2, MMP9 and TIMP1 in pericardium were analyzed by quantitative real-time polymerase chain reaction. The enrolled patients were divided into two groups according to the optimal cutoff value of gene expression predicting postoperative complications. Postoperative outcomes were compared between the two groups. Binary logistic regression analysis was performed to determine the degree of contribution of gene expression on postoperative outcomes. Results A total of 22 patients and their pericardial specimens were included. The level of MMP9 was significantly associated with postoperative complications and the optimal cutoff value predicting postoperative complications was 3.67. The patients with low level of MMP9 (< 3.67) had lower incidence of postoperative complications (P = 0.002), shorter postoperative intensive care unit (P = 0.040) and hospital stay (P = 0.043) in comparison to those with high level of MMP9 (≥ 3.67). Binary logistic regression analysis showed that high level of MMP9 increased risk of postoperative complications (OR, 27.096, 95%CI 1.166-629.886, P = 0.040). Conclusions High level of MMP9 in the pericardium was associated with poor postoperative outcomes and was the independent risk factor of postoperative complications. The level of MMP9 could be used as a potential marker for prediction of surgical outcomes.

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Does Percutaneous Achilles Tenotomy Yield Comparable Short-Term Outcomes to Combined Open Achilles Tenotomy with Posterior Capsulotomy in Pediatric Patients with Clubfoot?

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00152 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0015

Author(s):

Marine Coste ◽

Mikhail Tretiakov ◽

Neil V. Shah ◽

Daniel M. Zuchelli ◽

Joanne C. Dekis ◽

...

Keyword(s):

Postoperative Complications ◽

Multivariate Regression ◽

Pediatric Patients ◽

Operative Time ◽

Complication Rates ◽

Congenital Clubfoot ◽

Short Term ◽

Achilles Tenotomy ◽

Posterior Capsulotomy ◽

Reoperation Rates

Category: Hindfoot, Midfoot/Forefoot, Congenital Introduction/Purpose: As the most common musculoskeletal congenital anomaly, clubfoot (congenital talipes equinovarus) represents a commonly-encountered entity for pediatric orthopaedic and foot/ankle surgeons. As we have observed a shift towards more conservative, cost-conscious approaches to management, this study sought to compare short-term (30-day) perioperative and postoperative outcomes (complications and reoperations) in clubfoot patients who underwent either percutaneous Achilles tenotomy (PT) or combined open Achilles tenotomy with posterior capsulotomy (COTC). Methods: The National Surgical Quality Improvement Program (NSQIP) Pediatric Database was queried for all congenital clubfoot patients. Among those, patients who underwent percutaneous Achilles tenotomy (PT; CPT: 27606) or open Achilles tenotomy with posterior capsulotomy (COTC; CPT: 28262) were stratified into two cohorts. Cohorts were 1:1 propensity score-matched for gender, race, congenital clubfoot diagnosis, and ASA score. Demographics, peri- and 30-day postoperative data were collected for each group and compared using appropriate parametric tests. A p-value of 0.05 or lower indicated statistical significance. A binary stepwise multivariate regression model was used to assess the effects of age, gender, race, ASA score, congenital clubfoot, and surgery type on total complication and reoperation rates. Results: 690 patients were included (PT, n=345; COTC, n=345). PT patients were younger than COTC patients (1.58 vs. 4.26 years; p<0.001). However, gender and race distributions were comparable. PT patients incurred shorter operation-to-discharge intervals (0.24 vs. 1.1 days), total anesthesia (71.8 vs. 191.2 mins) and operative time (34.4 vs. 129.3 minutes) (all p<0.001). PT and COTC patients had comparable rates of postoperative complications (0.00 vs. 0.87%; p=0.082). Complications experienced by COTC patients included pneumonia (0.29%) and surgical site (0.29%), and urinary tract infections (0.29%). Both cohorts also had similar reoperation rates (0.58 vs. 1.45%; p=0.253). Multivariate regression analysis revealed that age, female sex, race, congenital clubfoot diagnosis, and type of surgery were not significantly associated with any increase in odds of incurring postoperative complications or reoperations. Conclusion: Patients who underwent PT were younger than those who underwent a COTC. In addition, COTCs were significantly longer and led to a greater length of stay than those who underwent PT. However, there was no significant difference in short-term post-operative complication and reoperation rates. Lastly, surgery type and operative time were not significant predictors for higher complication rates. Therefore, despite lengthier hospital stay and operative time for PT, COTC and PT had comparable and low short-term complication rates and appeared to be safe procedures for treatment of congenital clubfoot in pediatric patients.

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Effect of Smoking on Short-term Postoperative Complications After Elective Upper Extremity Surgery

Hand ◽

10.1177/1558944720926638 ◽

2020 ◽

pp. 155894472092663

Author(s):

Michael A. Del Core ◽

Junho Ahn ◽

Ann S. Golden ◽

Robert L. Bass ◽

Douglas Sammer ◽

...

Keyword(s):

Regression Analysis ◽

Postoperative Complications ◽

Upper Extremity ◽

Surgical Site Infections ◽

National Database ◽

Short Term ◽

Improvement Program ◽

Current Smoking ◽

The Impact ◽

Surgical Site Complications

Background: There is a paucity of literature exploring the impact of smoking on short-term complications, readmissions, and reoperations after elective upper extremity surgery using a large multicenter national database. We hypothesized that smokers will have an increased rate of complications, readmissions, and reoperations compared with a cohort of nonsmokers undergoing elective upper extremity surgery. Methods: Patient data were collected from the American College of Surgeons National Surgical Quality Improvement Program database between the years 2012 and 2017. Patients were included if they underwent elective surgery of the upper extremity using 338 predetermined Current Procedural Terminology codes. The data collected were divided into patient demographics, comorbidities, perioperative variables, and 30-day complications. Current smoking status was defined as smoking within 1 year prior to surgery. The incidence of surgical complications, reoperations, and readmissions was compared between the 2 cohorts using multivariable regression analysis. Results: Of the 107 943 patients undergoing elective surgeries of the upper extremity, 73 806 met the inclusion criteria. Of these, 57 986 (78.6%) were nonsmokers in the year prior to surgery, and 15 820 (21.4%) were current smokers. Between these groups, current smokers were younger ( P < .001), more often men ( P < .001), had lower body mass index ( P < .001), and more often underwent procedures that involved bone manipulation ( P < .001). Multivariate regression analysis defined current smoking as significantly associated with overall surgical site complications, superficial surgical site infections, deep surgical site infections, reoperation, and readmission. Conclusion: Current smoking was significantly associated with an increase in all surgical site complications, readmissions, and reoperations after elective upper extremity surgery. Surgeons should consider smoking a modifiable risk factor for postoperative complications and appropriately counsel patients on outcomes and complications given the elective nature of upper extremity surgery.

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Socioenvironmental criteria and postoperative complications in ambulatory surgery in a French university hospital: a prospective cross-sectional observational study

BMJ Open ◽

10.1136/bmjopen-2020-036795 ◽

2020 ◽

Vol 10 (11) ◽

pp. e036795

Author(s):

Sorina-Dana Mihailescu ◽

Isabelle Maréchal ◽

Denis Thillard ◽

André Gillibert ◽

Vincent Compère

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Postoperative Complications ◽

Observational Study ◽

Emergency Department Visit ◽

Public Transportation ◽

Ambulatory Surgery ◽

University Hospital ◽

Complication Rates ◽

Cross Sectional

BackgroundAmbulatory surgery lowers hospitalisation costs, shortens the time to return to work but requires caution regarding socioenvironmental risk factors for complications and rehospitalisation.MethodsThis was a single-centre prospective cross-sectional observational study conducted in a university hospital centrein January 2017. The primary objective was to assess the rate of conversion from ambulatory surgery to conventional hospitalisation or emergency department visit within 30 days following discharge from ambulatory unit. Secondary objectives were to describe the socioenvironmental characteristics of outpatients and to identify risk factors for severe postoperative complications.Results598 outpatients were included. The most represented surgical specialties were ophthalmology (23.5%), gynaecology (19%) and orthopaedics (17.7%). Patients’ mean age was 50.8 years (SD, 19.8) and the male/female sex ratio was 0.68. There were 22 (3.68%, 95% CI 2.32% to 5.52%) severe complications, including 11 (1.84%, 95% CI 0.92% to 3.27%) conversions to conventional hospitalisation and 11 (1.84%) conversions to emergency department visit, 3 of which led to readmission. Regarding socioenvironmental characteristics, 116 outpatients (19.7%) lived alone but were not isolated and 15 (2.6%) lived alone and were socially isolated. Following ambulatory surgery, 9 outpatients (1.6%) returned home on foot, 20 (3.4%) by public transportation and 8 (1.4%) drove home; 133 outpatients (13.7%) were alone the first night following surgery. Severe complication rates were not significantly different according to socioenvironmental subgroups.ConclusionIn our study, the prevalence of severe complications was low, conforming to the literature. The study was underpowered to estimate the effect of socioenvironmental variables.

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Surgical stabilization of concomitant canine medial patellar luxation and cranial cruciate ligament disease

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-16-10-0148 ◽

2017 ◽

Vol 30 (03) ◽

pp. 209-218

Author(s):

Albane Fauron ◽

Mieghan Bruce ◽

Daniel James ◽

Mark Owen ◽

Karen Perry

Keyword(s):

Logistic Regression ◽

Postoperative Complications ◽

Clinical Outcome ◽

Surgical Procedure ◽

Cruciate Ligament ◽

Postoperative Outcome ◽

Tibial Tuberosity ◽

Complication Rates ◽

Cranial Cruciate Ligament ◽

Referral Hospitals

SummaryObjectives: To compare complication rates and outcomes between cases of concomitant cranial cruciate ligament (CrCL) disease and medial patellar luxation (MPL) treated using extracapsular stabilization and tibial tuberosity transposition (ECS+TTT) and tibial tuberosity transposition and advancement (TTTA).Methods: In a multicentre retrospective study, records from four referral hospitals were reviewed for dogs with concomitant CrCL pathology and MPL treated using ECS+TTT or TTTA. Data retrieved included signalment, partial/complete CrCL tear, MPL grade, treatment performed, occurrence of postoperative complications, and postoperative outcome grade. Associations between surgical procedure and risk of complication and surgical procedure and outcome were investigated using univariable logistic regression and proportional odds logistic regression respectively. Multiple logistic regression was used to explore confounding factors.Results: A total of 72 stifles were evaluated in 66 dogs; 32 stifles were stabilized using ECS+TTT and 40 using TTTA. Overall complications were 2.7 times more frequent in the ECS+TTT group and major complications occurred only in this group. The TTTA group was less likely to suffer complications (17.5%) compared to the ECS+TTT group (46.9%) (p = 0.009) and TTTA cases had lower odds of a poorer clinical outcome (p = 0.047).Clinical significance: Stifles stabilized using ECS+TTT are more likely to suffer from postoperative complications and a poorer clinical outcome when compared to TTTA.Supplementary Material to this article is available online at https://doi.org/10.3415/VCOT-16-10-0148

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Isolated hip fracture in the elderly and time to surgery: is there an outcome difference?

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2018-000212 ◽

2018 ◽

Vol 3 (1) ◽

pp. e000212 ◽

Cited By ~ 2

Author(s):

Adel Elkbuli ◽

Alyssa Eily ◽

Valerie Polcz ◽

Dessy Boneva ◽

Paul J Spano II ◽

...

Keyword(s):

Hip Fracture ◽

Postoperative Complications ◽

Surgical Intervention ◽

The Elderly ◽

Future Research ◽

P Value ◽

Complication Rates ◽

Time To Surgery ◽

Life Years ◽

Significant Difference

BackgroundEarly operative intervention for hip fractures in the elderly is advised to reduce mortality and morbidity. Postoperative complications impose a significant burden on patient outcomes and cost of medical care. Our aim was to determine the relationship between time to surgery and postoperative complications/mortality in patients with hip fracture.MethodsThis is a retrospective review of data collected from our institution’s trauma registry for patients ≥65 years old with isolated hip fracture and subsequent surgery from 2015 to 2017. Patients were stratified into two groups based on time to surgery after admission: group 1: <48 hours versus group 2: >48 hours. Demographic variables included age, gender, race, and Injury Severity Score (ISS). The outcome variables included intensive care unit length of stay (ICU-LOS), deep venous thrombosis (DVT), pulmonary embolism (PE) rate , mortality, and 30-day readmission rates. Analysis of variance was used for analysis, with significance defined as a p value <0.05.ResultsA total of 485 patients with isolated hip fracture required surgical intervention. Of those, 460 had surgery <48 hours and 25 had surgery >48 hours postadmission. The average ISS was the same in both groups. The average ICU-LOS was significantly higher in the >48 hours group compared with the <48 hours group (4.0 vs. 2.0, p<0.0002). There was no statistically significant difference between groups when comparing DVTand PE rate, 30-day readmission, or mortality rates.DiscussionTime to surgery may affect overall ICU-LOS in patients with hip fracture requiring surgical intervention. Time to surgery does not affect complication rates, 30-day readmission, or mortality. Future research should investigate long-term outcomes such as functional status and disability-adjusted life years.Level of evidenceIII. Retrospective/ prognostic cohort study

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Short-Periods of Pre-Warming in Laparoscopic Surgery. A Non-Randomized Clinical Trial Evaluating Current Clinical Practice

Journal of Clinical Medicine ◽

10.3390/jcm10051047 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1047

Author(s):

Ángel Becerra ◽

Lucía Valencia ◽

Jesús Villar ◽

Aurelio Rodríguez-Pérez

Keyword(s):

Clinical Practice ◽

Postoperative Complications ◽

Temperature Drop ◽

Surgical Site Infections ◽

Tertiary Hospital ◽

Tympanic Temperature ◽

Anesthesia Induction ◽

Current Clinical Practice ◽

Short Term ◽

Urological Surgery

Background: Pre-warming prevents perioperative hypothermia. We evaluated the current clinical practice of pre-warming and its effects on temperature drop and postoperative complications; Methods: This prospective, observational pilot study examines clinical practice in a tertiary hospital on 99 patients undergoing laparoscopic urological surgery. Pre-warming was performed in the pre-anesthesia room. Patients were classified into three groups: P 0 (non-prewarmed), P 5–15 (pre-warming 5–15 min) and P > 15 (pre-warming 15–30 min). Tympanic temperature was recorded in the pre-anesthesia room, prior to anesthesia induction, and in the PACU. Esophageal temperature was recorded intraoperatively. The occurrence of shivering, pain intensity, length of stay in PACU, and postoperative complications during hospital stay were also recorded; Results: After pre-warming, between-group difference in body temperature was higher in P > 15 than in P 0 (0.4 °C, 95% CI 0.14–0.69, p = 0.004). Between P 5–15 and P 0 difference was 0.2 °C (95% CI 0.04–0.55, p = 0.093). Temperature at the end of surgery was higher in pre-warmed groups [mean between-group difference 0.5 °C (95% CI 0.13–0.81, p = 0.007) for P 5–15; 0.9 °C (95% CI 0.55–1.19, p < 0.001) for P > 15]. Pain and shivering was less common in pre-warmed groups. Postoperative transfusions and surgical site infections were lower in P > 15; Conclusion: Short-term pre-warming prior to laparoscopic urological surgery decreased temperature perioperative drop and postoperative complications.

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A Nationwide Analysis of Preoperative Planning on Operative Times and Postoperative Complications in Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0039-1677790 ◽

2019 ◽

Vol 32 (11) ◽

pp. 1040-1045 ◽

Cited By ~ 2

Author(s):

Nipun Sodhi ◽

Hiba K. Anis ◽

Marine Coste ◽

Joseph O. Ehiorobo ◽

Alexander Chee ◽

...

Keyword(s):

Logistic Regression ◽

Postoperative Complications ◽

Preoperative Planning ◽

Inverse Correlation ◽

Surgical Site Infections ◽

Living Environment ◽

Improvement Program ◽

Risk Factor Modification ◽

Primary Tkas ◽

Total Knee

AbstractCompared with nonelective total knee arthroplasties (TKAs), elective procedures have more time for preoperative planning, which allows for potentially improved patient optimization, risk factor modification, and patient education. The purpose of this study was to (1) determine nationwide trends in operative times and (2) evaluate associations between surgery type, elective or nonelective, with respect to (a) operative times, (b) length of stay (LOS), (c) discharge dispositions, (d) 30-day postoperative complications, (e) reoperations, and (f) readmissions. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for all primary TKAs performed between 2011 and 2016. This yielded 209,178 cases which were stratified into elective and nonelective cases. Elective cases were those in which patients were brought from their normal living environment for scheduled procedures. One-way ANOVA (analysis of variance) was used to evaluate associations between operative times and year of surgery. Multivariate linear and logistic regression models adjusted for surgery year and patient factors (age, sex, BMI [body mass index], and ASA [American Society of Anesthesiologists] score) were used to evaluate associations of surgery type with peri- and postoperative outcomes. A significant inverse correlation between operative times and operative year was observed (p < 0.001). Mean operative times and LOS were significantly shorter in elective cases compared with nonelective cases (93 vs. 112 minutes, p < 0.005; 3 vs. 5 days, p < 0.001). Multivariate analysis showed these associations remained significant even after adjusting for potential confounders (p < 0.001). Compared with the nonelective cohort, patients in the elective cohort were more likely to be discharged home (74 vs. 69%, p < 0.001). Nonelective patients had higher rates of pneumonia (0.7 vs. 0.3%, p = 0.005), organ-space surgical site infections (SSI; 0.4 vs. 0.2%, p = 0.004), transfusions (10.9 vs. 6.5%, p < 0.001), sepsis (0.6 vs. 0.2%, p = 0.001), and septic shock (0.2 vs. 0.1%, p = 0.005) compared with elective patients. These associations remained significant with multivariate logistic regression. This study demonstrated that preoperative planning can help shorten operative times and LOS as well as reduce complication and reoperation rates. Alongside the direct advantages identified in this study, potential greater effects include superior patient outcomes and reduced health care costs.

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