Factors Contributing to Extended Hospital Length of Stay in Emergency General Surgery

Samer T. Elsamna, Saif Hasan, Michael E. Shapiro, Aziz M. Merchant

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Emergency general surgery (EGS) is a field characterized by disproportionately high costs, post-operative mortality, and complications. We attempted to identify independent factors predictive of an increased postoperative length of stay (LOS), a key contributor to economic burden and worse outcomes. Methods: The ACS-NSQIP database was queried for data from2005 to 2017. Current procedural terminology (CPT) codes were used to identify the most commonly performed EGS procedures: appendectomy, bowel resection, colectomy, and cholecystectomy. Cohorts above and below 75th percentile LOS were determined, compared by preoperative variables, and evaluated with univariate and multivariate logistic regression to quantify risk. Results: Of 267,495 cases, 70,703 cases were above the 75th percentile for LOS. A larger proportion of patients in the extended LOS group were 41 years or older (88.6% vs 45.7%). More Blacks (10.3% vs 6.7%) were observed in the extended LOS group. Age, race, cardiopulmonary, hepatic, and renal disease, diabetes, recent weight loss, steroid use, and sepsis history were significant factors on multivariate analysis but varied in terms of risk proportion by procedure. Age (61+), Black race, hypertension, sepsis, and cancer were significant for all 4 procedures. Conclusions: Several factors are independently associated with extended LOS for those undergoing the most common EGS procedures. Five of these were associated with an increased LOS for all four procedures. These included, age (61+), hypertension, sepsis, cancer, and Black race.

Original languageEnglish (US)
Pages (from-to)1399-1406
Number of pages8
JournalJournal of Investigative Surgery
Issue number12
StatePublished - 2021

All Science Journal Classification (ASJC) codes

  • Surgery


  • Emergency
  • general surgery
  • length of stay


Dive into the research topics of 'Factors Contributing to Extended Hospital Length of Stay in Emergency General Surgery'. Together they form a unique fingerprint.

Cite this