A Prospective Cohort Analysis of the Prevalence and Predictive Factors of Delayed Discharge After Laparoscopic Cholecystectomy in Italy: The DeDiLaCo Study
- Authors: Cillara N.; Podda M.; Cicalò E.; Sotgiu G.; Provenzano M.; Fransvea P.; Poillucci G.; Sechi R.; Deserra A.; D'Agostino F.; Margiani C.; Scabini S.; Pertile D.; De Rosa R.; Prosperi P.; Bruscino A.; Bella A.D.; Casati M.; Laface L.; Abate E.; Frontali A.; Bonomi A.M.; Ferrario L.; Mucilli F.; Barone M.; Borghi F.; Sasia D.; Giraudo G.; Puzziello A.; Loffredo A.; Steccanella F.; Donnarumma E.; Galleano R.; Malerba M.; Runfola M.; Agus M.; Fortunato F.; Calò P.G.; Medas F.; Canu G.L.; Stella M.; Ferrara F.; Baldi C.; Benuzzi L.; Pisanu A.; Saba A.; Gessa E.; Muratore A.; Calabrò M.; Cuzzola B.; Garino M.; Marafante C.; Farfaglia R.; Pandolfo G.; Pata G.; Lantone G.; Marino F.; Perrone F.; Scognamillo F.; Delogu D.; Tilocca P.L.; Frena A.; Malpaga A.; Bertelli G.; Memeo R.; Ferraro V.; Libia A.; Sarro G.; Marconi M.; Nava S.; Pierpaolo B.; Fleres F.; Clarizia G.; Alfieri S.; Rosa F.; Longo F.; Restini E.; Cianci P.; Capuzzolo S.; Anania G.; Bombardini C.; Urbani A.; Bona D.; Aiolfi A.; Lastraioli C.; Paola M.D.; Dall'oglio A.; D'Eletto M.; Capelli P.; Conti L.; Luzietti E.; Banchini F.; Manca G.; Calo G.; Centomze A.; Andreano M.; Sullo P.; Giuseppina O.; Anastasi A.; Canonico G.
- Publication year: 2023
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/617594
Abstract
Background: The concept of early discharge <= 24 hours after Laparoscopic Cholecystectomy (LC) is still doubted in Italy. This prospective multicentre study aims to analyze the prevalence of patients undergoing elective LC who experienced a delayed discharge > 24 hours in an extensive Italian national database and identify potential limiting factors of early discharge after LC. Methods: This is a prospective observational multicentre study performed from January 1, 2021 to December 31, 2021 by 90 Italian surgical units. Results: A total of 4664 patients were included in the study. Clinical reasons were found only for 850 patients (37.7%) discharged > 24 hours after LC. After excluding patients with nonclinical reasons for delayed discharge > 24 hours, 2 groups based on the length of hospitalization were created: the Early group (<= 24 h; 2414 patients, 73.9%) and the Delayed group (> 24 h; 850 patients, 26.1%). At the multivariate analysis, ASA III class (P < 0.0001), Charlson's Comorbidity Index (P = 0.001), history of choledocholithiasis (P = 0.03), presence of peritoneal adhesions (P < 0.0001), operative time > 60 min (P < 0.0001), drain placement (P < 0.0001), pain (P = 0.001), postoperative vomiting (P = 0.001) and complications (P < 0.0001) were independent predictors of delayed discharge > 24 hours. Conclusions: The majority of delayed discharges > 24 hours after LC in our study were unrelated to the surgery itself. ASA class > II, advanced comorbidity, the presence of peritoneal adhesions, prolonged operative time, and placement of abdominal drainage were intraoperative variables independently associated with failure of early discharge.