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Session: ePoster Monitor 7-Quality and Cost 6

eP631 - Minimally Invasive Colectomy Leads to Reduced Length of Stay in the Octogenarian: A Retrospective Cohort Study Using the ACS-NSQIP Dataset

Monday, June 3, 2024
10:24 AM – 10:29 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Justin Dourado, MD (he/him/his)

    General Surgery Resident
    Florida Atlantic University
    Florida Atlantic University
    Delray Beach, FL, United States

    All relevant financial disclosures have been managed and will be listed below.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • PA

    Pauline Aeschbacher, MD

    Physician
    Department for Visceral Surgery and Medicine, Bern University Hospital, Bern, Switzerland
    Bern, Bern, Switzerland

    Disclosure information not submitted.

  • PR

    Peter Rogers, MD, BSc

    Resident
    University of Western Australia
    Weston, Florida, United States

    Disclosure information not submitted.

  • JM

    Jordan Moseson, DO, FACS, FASCRS

    Affiliate Associate Professor of Clinical Sciences
    Florida Atlantic University, Dept of Surgery
    Delray Beach, Florida, United States

    Disclosure information not submitted.

  • AR

    Andrew S. Ross, MD, MD FACS FASCRS

    Clinical Associate Professor of Surgery
    Florida Atlantic University School of Medicine
    Boca Raton, Florida, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • AB

    Avraham Belizon, MD, FACS, FASCRS

    Associate Director of CRS Baptist Medical Center North, Director of robotic surgery training program
    Florida Atlantic University
    Boca Raton, Florida, United States

    Disclosure information not submitted.

Purpose/Background: Surgery in the octogenarian is often associated with worse outcomes and increasing complications. This is likely due to the increased rate of medical comorbidities and decreasing functional status among patients in this group. Our study aims to assess if the implementation of minimally invasive colectomy is safe and effective in the octogenarian.Methods/Interventions: This is a retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database analyzing all patients undergoing colectomy at Boca Raton Regional Hospital from October 15, 2020 to August 10, 2023. Patients under the age of 18 and with incomplete data were excluded. Chi-square or Fischer’s exact tests were used to analyze categorical variables as appropriate. Student t-test or Mann-Whitney U-tests were used to analyze continuous variables, as appropriate. A p < .05 was considered statistically significant and analyses were done using EZR and R software.Results/Outcomes: 276 patients met inclusion criteria for the study with 51 (18.5%) being over the age of 80 and 225 (81.5%) being younger than 80. 105 (38.0%) of the cohort were males. Indication for surgery did not differ between groups (p=0.817) When comparing octogenarians with younger patients, there were higher rates of heart failure (p=0.079), disposition to a facility other than home (p < 0.001), higher modified frailty index (mFI) (p < 0.001), higher rate of blood transfusion within 72 hours (p=0.02), and length of stay post-operatively (6 v 4 days, p=0.089). There were no differences in post-operative rates of myocardial infarction (p=0.185), superficial (p=0.702), deep (p=0.185), or organ space (p=1) surgical site infection (SSI), dialysis (p=1), pneumonia (p=1), pulmonary embolism (p=1), unplanned intubation (p=0.561), requirement for a ventilator > 48 hours (p=0.46), or 30-day mortality (p=0.174). When this cohort was stratified by those patients who underwent minimally invasive surgery only, they continued to require higher blood transfusion within 72 hours (p=0.043) and remained without a significant difference in any other complications when compared to those younger than 80. Octogenarian length of stay decreased and became comparable to younger patients (4 v 3 days, p=0.224).Conclusion/

Discussion: Minimally invasive colectomy is safe in the octogenarian with a reduced length of stay that is comparable to younger patients. This supports the assertion that, when technically feasible, octogenarians experience benefit from a minimally invasive approach to colectomy without increased complications.