Authors:
Gianmauro Numico, Elena Fea, […], and Alessandro Audisio, +13 (View all authors)
Abstract
Hospital admission is frequently required in the cancer trajectory. In a context of bed shortage, pressure on Emergency Departments and increasing healthcare costs, promoting actions that contain hospital stay is a priority. We studied the variables able to predict longer hospital stays.
We retrospectively retrieved data on consecutive admissions in our cancer inpatient unit in a 6-month period and assessed individual and clinical variables potentially related with duration of hospital stay through univariate and multivariate analysis.
Among the 147 included admissions, mean overall duration of hospital stay was 8.46 days (95% I.C. 8.36 to 8.55). Significant differences were shown for two clusters of variables: 1) the clinical condition causing admission: non-controlled disease vs responding disease (10.0 vs 6.8 days, p: 0.006); cancer-related symptoms vs acute events (not directly cancer-related) or toxicity (9.8 – 6.0 – 7.2 days, respectively; p: 0.05). 2) The discharge modality: discharge at home (6.2 days) vs assisted discharge either at home or in a long-term structure or in hospice (11.0 and 12.5 days, respectively; p: 0.0001). Disease control and discharge modality retained statistical significance also in the multivariate analysis.
Admissions for which a long hospital stay is advisable can be anticipated from patients’ entry. Actions on faster symptom control and discharge preparedness may have a strong impact on duration of stay and on bed availability.