Riccardo Lemini1, Iktej S Jabbal1, Krystof Stanek1, Shalmali R Borkar2, Aaron C Spaulding2, Scott R Kelley3, Dorin T Colibaseanu4. 1. Division of Colon and Rectal Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA. 2. Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA. 3. Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA. 4. Division of Colon and Rectal Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA. colibaseanu.dorin@mayo.edu.
Abstract
BACKGROUND: This study aimed to identify socioeconomic predictors of permanent stoma in rectal cancer treatment and examine its association with length of stay at the treatment facility. METHODS: Rectal cancer patients who underwent elective surgery between January 2015 and December 2018 were identified from the Agency for Health Care Administration Florida Hospital Inpatient Discharge Dataset. Multivariate regression models were utilized to identify demographic and socioeconomic factors associated with receiving a permanent stoma as well as the associated length of stay of these patients. RESULTS: Of 2630 rectal cancer patients who underwent surgery for rectal cancer, 21% had a permanent stoma. The odds of receiving permanent stoma increased with higher Elixhauser score, metastatic disease, advanced age, having open surgery, residence in Southwest Florida, and having Medicaid insurance or no insurance/self-payers (p < 0.05). Patients with a permanent stoma had a significantly extended stay after surgery (p < 0.001). CONCLUSIONS: Patients with a permanent stoma following cancer resection were more likely to have open surgery, had more comorbidities, and had a longer length of stay. Having permanent stoma was higher in patients living in South West Florida, patients with Medicaid insurance, and in the uninsured. Additionally, the payer type significantly affected the length of stay.
BACKGROUND: This study aimed to identify socioeconomic predictors of permanent stoma in rectal cancer treatment and examine its association with length of stay at the treatment facility. METHODS: Rectal cancerpatients who underwent elective surgery between January 2015 and December 2018 were identified from the Agency for Health Care Administration Florida Hospital Inpatient Discharge Dataset. Multivariate regression models were utilized to identify demographic and socioeconomic factors associated with receiving a permanent stoma as well as the associated length of stay of these patients. RESULTS: Of 2630 rectal cancerpatients who underwent surgery for rectal cancer, 21% had a permanent stoma. The odds of receiving permanent stoma increased with higher Elixhauser score, metastatic disease, advanced age, having open surgery, residence in Southwest Florida, and having Medicaid insurance or no insurance/self-payers (p < 0.05). Patients with a permanent stoma had a significantly extended stay after surgery (p < 0.001). CONCLUSIONS:Patients with a permanent stoma following cancer resection were more likely to have open surgery, had more comorbidities, and had a longer length of stay. Having permanent stoma was higher in patients living in South West Florida, patients with Medicaid insurance, and in the uninsured. Additionally, the payer type significantly affected the length of stay.
Entities:
Keywords:
Colorectal surgery; Disparities; Length of stay; Outcomes; Rectal cancer; Stoma; Surgery
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