eP321 - Frailty and Rectal Prolapse Repair: An Analysis of the National Inpatient Sample for Clinical Outcomes and Health Resource Utilization

Sunday, June 2, 2024

11:33 AM – 11:38 AM ET, USA

Location: Baltimore Convention Center, Room 318-320

ePoster Presenter(s)

Janhavi Patel, MD

General Surgery Resident
McMaster University
McMaster University
Hamilton, ON, Canada

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

GJ

Ghazal Jessani, HBSc, M.ED, MD candidate

Medical Student
McMaster University
Mississauga, Ontario, Canada

Disclosure information not submitted.
Tyler McKechnie, MD, MSc (he/him/his)

Resident Physician
McMaster University
McMaster University
Hamilton, ON, Canada

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

CE

Cagla Eskicioglu, MD, Msc, FRCSC

Associate Professor, Colon & Rectal Surgeon
Faculty of Health Sciences, McMaster University
Hamilton, Ontario, Canada

Disclosure information not submitted.

Author(s)

NA

Nalin Amin, MD, FRCS(C)

Associate Professor
McMaster University
Ancaster, Ontario, Canada

Disclosure information not submitted.
DH

Dennis Hong, MD, M.S.c, FRCSC, FACS

Associate Professor
McMaster University
Hamilton, Ontario, Canada

Disclosure information not submitted.
AD

Aristithes Doumouras, MD, MPH

Assistant Professor
McMaster University
Hamilton, Ontario, Canada

Disclosure information not submitted.
YL

Yung Lee, MD MPH

Resident
McMaster University
Hamilton, Ontario, Canada

Disclosure information not submitted.

Purpose/Background: Rectal prolapse generally affects elderly and frail individuals. However, there is a lack of data on the impact of frailty on post-operative outcomes for rectal prolapse repair. The purpose of this retrospective study was to utilize the National Inpatient Sample (NIS) and the modified frailty index (mFI-11) to compare outcomes between frail and robust patients undergoing rectal prolapse repair.Methods/Interventions: A retrospective cohort study was conducted using the Healthcare Cost and Utilization Project (HCUP) NIS from 2015 to 2019. The population of interest was patients with rectal prolapse undergoing operative repair according to ICD-10 coding. The mF-11 was employed to identify frail and robust individuals. The primary outcomes included postoperative morbidity and mortality. Secondary outcomes included system-specific postoperative morbidity, length of stay (LOS), total in-hospital healthcare cost, and discharge disposition. Univariable and multivariable regression analyses were performed.Results/Outcomes: The final analysis included 2,130 patients, comprising 239 frail (mFI > 0.27) and 1,891 robust patients (mFI < 0.27). Frail patients exhibited higher mortality (OR 10.38, 95% CI 0.65-166.59, p=0.098) and morbidity (OR 2.18, 95% CI 1.31-3.63, p=0.003) than robust patients. Frail patients also had longer length of stay (MD 1.60 days, 95%CI 1.05-2.44, p=0.028), were less likely to be discharged to home (OR 0.47, 95% CI 0.30-0.74, p=0.001), more likely to be transferred to a nursing care facility (OR 1.60, 95% CI 0.88-2.89, p=0.120) and increased treatment-related costs (MD $15,561.56, 95%CI -6,023.12-37,146.25, p=0.157).Conclusion/

Discussion: Frailty increases mortality, morbidity, and imposes a greater financial burden on the health system in patients undergoing surgery for rectal prolapse. Insights from this study underscore the need for preoperative assessment and development of strategies to address frailty, thereby optimizing patients before rectal prolapse surgery.