Predictive Factors of Health Discharge Outcomes for Colorectal Cancer Patients in a Romanian Hospital

Anamaria Nicoleta Crenguța Petrișor 1 , 2 , Alina Ioana Forray 1 , 3 , Cristina Maria Borzan 1 , Bogdan Florin Covaliu 1 , Florina Gabor-Harosa 1 ,  and Carmen Daniela Domnariu 2 , 2
  • 1 “Iuliu Hațieganu” University of Medicine and Pharmacy, , Cluj Napoca
  • 2 “Lucian Blaga” University of Sibiu,
  • 3 “Babeș-Bolyai” University, , Cluj Napoca

Abstract

In-hospital data on colorectal cancer from Romania demonstrate differences from other European countries, especially in the mean age of patients, discharge rates and length of stay. Our study aimed to investigate possible factors that could predict the health outcomes at the discharge of colorectal cancer patients hospitalized in a Romanian county hospital. We retrospectively analysed 9009 colorectal cancer patients from a Romanian County Hospital. The model of binary logistic regression, a stationary or aggravated discharge disposition was associated with patients with age equal or higher than 60 years (p=0.002), the nonretirement status of patients (p=0.004), discharge from a surgical section (p=0.000), a surgical procedure performed during the hospitalization period (p=0.000) and a hospitalization period shorter than seven days (p=0.000). Potentially actionable demographic and hospital-level characteristics can predict colorectal cancer health outcomes of patients at discharge. Knowledge of this information would allow for several strategies that could improve the discharge planning.

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  • 1. Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M, et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer (Internet). 2018;103:356-87. Available from: https://doi.org/10.1016/j.ejca.2018.07.005.

  • 2. Rabeneck L, Chiu HM, Senore C. International Perspective on the Burden of Colorectal Cancer and Public Health Effects. Gastroenterology (Internet). 2020;158(2):447-52. Available from: https://doi.org/10.1053/j.gastro.2019.10.007.

  • 3. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.

  • 4. Ionescu EM, Tieranu CG, Maftei D, Grivei A, Olteanu AO, Arbanas T, et al. Colorectal Cancer Trends of 2018 in Romania-an Important Geographical Variation Between Northern and Southern Lands and High Mortality Versus European Averages. J Gastrointest Cancer (Internet). 2020; Available from: https://doi.org/10.1007/s12029-020-00382-3.

  • 5. McCann A, Sorensen J, Nally D, Kavanagh D, McNamara DA. Discharge outcomes among elderly patients undergoing emergency abdominal surgery: registry study of discharge data from Irish public hospitals. BMC Geriatr. 2020;20(1):72.

  • 6. Ommundsen N, Nesbakken A, Wyller TB, Skovlund E, Bakka AO, Jordhøy MS, et al. Post-discharge complications in frail older patients after surgery for colorectal cancer. Eur J Surg Oncol (Internet). 2018;44(10):1542-7. Available from: https://doi.org/10.1016/j.ejso.2018.06.024.

  • 7. Kim S, Lee SC, Skinner CS, Brown CJ, Balentine CJ. A Surgeon’s Guide to Treating Older Patients with Colorectal Cancer. Curr Colorectal Cancer Rep. 2019;15(1).

  • 8. Lee MTG, Chiu CC, Wang CC, Chang CN, Lee SH, Lee M, et al. Trends and Outcomes of Surgical Treatment for Colorectal Cancer between 2004 and 2012- An Analysis using National Inpatient Database. Sci Rep (Internet). 2017;7(1):1-8. Available from: http://dx.doi.org/10.1038/s41598-017-02224-y.

  • 9. Mohanty S, Liu Y, Paruch JL, Kmiecik TE, Cohen ME, Ko CY, et al. Risk of discharge to postacute care: A patient-centered outcome for the American College of Surgeons National Surgical Quality Improvement Program surgical risk calculator. JAMA Surg. 2015;150(5):480-4.

  • 10. Saini SD, Vijan S, Schoenfeld P, Powell AA, Moser S, and Kerr EA. Role of quality measurement in inappropriate use of screening for colorectal cancer: Retrospective cohort study, BMJ. 2014;348 Feb:1–8. https://doi.org/10.1136/bmj.g1247.

  • 11. Damle RN, Alavi K. Risk factors for 30-d readmission after colorectal surgery: A systematic review. J Surg Res (Internet). 2015;200(1):200-7. Available from: http://dx.doi.org/10.1016/j.jss.2015.06.052.

  • 12. Vladescu C, Scintee SG, Olsavszky V, Hernandez-Quevedo C, Sagan A. Romania: Health System Review. Health Syst Transit (Internet). 2016;18(4):1-170. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27603897.

  • 13. Dodd N, Carey M, Mansfield E. Knowledge of colorectal cancer risk factors and screening recommendations: A crosssectional study of regional Australian general practice patients. Public Heal Res Pract. 2017;27(5):0-3.

  • 14. Ommundsen N, et al. Post-discharge complications in frail older patients after surgery for colorectal cancer, Eur J Surg Oncol. 2018;44(10):1542-1547. doi: 10.1016/j.ejso.2018.06.024.

  • 15. Greco M, Capretti G, Beretta L, Gemma M, Pecorelli N, Braga M. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials. World J Surg. 2014;38:1531-1541. https://doi.org/10.1007/s00268-013-2416-8.

  • 16. Price BA, Bednarski BK, You YN, Manandhar M, Dean EM, Alawadi ZM, et al. Accelerated enhanced Recovery following Minimally invasive colorectal cancer surgery (RecoverMI): A study protocol for a novel randomised controlled trial. BMJ Open. 2017;7(7):1-6.

  • 17. Pucciarelli S, et al. In-hospital mortality, 30-day readmission, and length of hospital stay after surgery for primary colorectal cancer: A national population-based study, Eur J Surg Oncol. 2017;43(7):1312-1323. https://doi.org/10.1016/j.ejso.2017.03.003.

  • 18. Bartlett EK, Hoffman RL, Mahmoud NN, Karakousis GC, Kelz RR. Postdischarge occurrences after colorectal surgery happen early and are associated with dramatically increased rates of readmission. Dis Colon Rectum. 2014;57:1309-16.

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