ArticleAnnals of surgery1999
Risk factors for prolonged length of stay after major elective surgery.
Article in Annals of surgery, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 155 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
155 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Artificial Intelligence for Predicting Length of Stay for General Surgery Patients: A Systematic Review.World journal of surgery · 2026Pooled it
- Alvimopan for postoperative ileus following abdominal surgery: a systematic review.Langenbeck's archives of surgery · 2024Pooled it
- Textbook Outcomes in Liver Surgery: a Systematic Review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Pooled it
- Effect of hospital volume on outcomes of total hip arthroplasty: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2019Pooled it
- Precision diagnosis: a view of the clinical decision support systems (CDSS) landscape through the lens of critical care.Journal of clinical monitoring and computing · 2017Pooled it
- Meta-analysis on the efficacy of tourniquet on ankle trauma surgery.European journal of medical research · 2013Pooled it
- Complications for racial and ethnic minority groups after total hip and knee replacement: a review of the literature.The Journal of bone and joint surgery. American volume · 2010Pooled it
- Alvimopan, a novel, peripherally acting mu opioid antagonist: results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial of major abdominal surgery and postoperative ileus.Annals of surgery · 2004Pooled it
- Perioperative Normobaric Hyperoxia Combined With Pulmonary Rehabilitation Intervention for Enhanced Short-Term Recovery in Lung Cancer Surgery.Thoracic cancer · 2026Trial
- Association between Blood Potassium Level and Recovery of Postoperative Gastrointestinal Motility during Continuous Renal Replacement Therapy in Patient Undergoing Open Abdominal Surgery.BioMed research international · 2019Trial
- A Competing-Risk Approach for Modeling Length of Stay in Severe Malaria Patients in South-East Asia and the Implications for Planning of Hospital Services.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Alvimopan, a peripherally acting mu-opioid receptor antagonist, compared with placebo in postoperative ileus after major abdominal surgery: results of a randomized, double-blind, controlled study.Surgical endoscopy · 2006Trial
- Portal vein embolization before right hepatectomy: prospective clinical trial.Annals of surgery · 2003Trial
- Predictors for failed same-day discharge after total shoulder arthroplasty.Journal of shoulder and elbow arthroplasty · 2026Article
- Article
- Comparing non-operative management of abdominal solid organ injuries in pediatric and adult blunt trauma: A meta-analysis and systematic review.Irish journal of medical science · 2026Review
- Changing Patterns in Hospitalisations of Patients with Systemic Lupus Erythematosus over Three Decades at a Tertiary Referral Centre in Catalonia.Journal of clinical medicine · 2026Article
- Heterogeneity Within Frailty: Physiological Reserve Phenotypes and Postoperative Recovery After Abdominal Surgery.Journal of clinical medicine · 2026Article
- Using latent class analysis to identify subgroups of postoperative older adults.SAGE open medicine · 2026Article
- A nomogram for predicting free flap necrosis in soft tissue reconstruction of lower limbs: a retrospective cohort study.Frontiers in medicine · 2026Article
95 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveLength of stay (LOS) is an important outcome as a marker of resource consumption. Determining which factors increase LOS may provide information on reducing costs and improving the delivery of care. The purpose of this study was to determine the independent association of intraoperative process of care and postoperative events with prolonged LOS after adjusting for preoperative severity of illness in patients undergoing major elective surgery.
methodsCases representing 11 elective operations from the National VA Surgical Quality Improvement Program were analyzed using multivariate logistic regression analysis. The outcome, prolonged LOS, was defined as an LOS greater than or equal to the 75th percentile (in days) for each operation. Hierarchical modeling was used to assess the independent association of groups of variables (preoperative patient characteristics, intraoperative process of care, and postoperative adverse events) with prolonged LOS.
resultsFor the 11 operations explored, there were 23,919 cases. Common preoperative variables associated with prolonged LOS were functional status, American Society of Anesthesiology class, and age. The most predictive intraoperative and postoperative variables included intraoperative blood transfusion, operative time, return to the operating room, and the number of complications after surgery.
conclusionsProlonged LOS is associated with preoperative, intraoperative, and postoperative factors. Although preoperative factors were independently associated with a prolonged LOS, the factors generating the highest risks for a prolonged LOS were the intraoperative process of care and postoperative adverse events. To reduce costs, efforts should be made to improve the intraoperative process of care and to minimize postoperative complications.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.