Association between patient activation and delayed discharge in elective laparoscopic cholecystectomy: A prospective cohort analysis

Improving patient activation may be an effective way to reduce healthcare costs and improve patient outcomes after surgery. To determine whether preoperative patient activation is associated with delayed discharge (i.e., length of stay >24 h) after elective laparoscopic cholecystectomy. Postopera...

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Bibliographic Details
Published in:International journal of nursing studies 2024-06, Vol.154, p.104751-104751, Article 104751
Main Authors: Provenzano, Maria, Cillara, Nicola, Podda, Mauro, Cicalò, Enrico, Sotgiu, Giovanni, Fransvea, Pietro, Poillucci, Gaetano, Sechi, Raffaele, Deserra, Antonello, Jiménez-Herrera, Maria
Format: Article
Language:English
Subjects:
Delayed discharge
Laparoscopic cholecystectomy
Patient activation
Patient engagement
Surgical outcomes
Unplanned healthcare utilization
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Summary:Improving patient activation may be an effective way to reduce healthcare costs and improve patient outcomes after surgery. To determine whether preoperative patient activation is associated with delayed discharge (i.e., length of stay >24 h) after elective laparoscopic cholecystectomy. Postoperative symptoms, unscheduled access to healthcare facilities within seven days of surgery, unplanned hospital readmissions, and postoperative complications were analyzed as secondary outcomes. This cohort study was a secondary analysis of the DeDiLaCo study (Delayed Discharge after day-surgery Laparoscopic Cholecystectomy) collecting data of patients undergoing elective laparoscopic cholecystectomy during 2021 in Italy. Data was analyzed from June 2022 to April 2023. 90 Italian surgical centers participating in the study. 4708 adult patients with an instrumental diagnosis of gallbladder disease and undergoing laparoscopic cholecystectomy. Patient activation was assessed using the Italian translation of Patient Activation Measure in the preoperative setting. Of 4532 cases analyzed the median (IQR) Patient Activation Measure score was 80.3 (71.2–92.3). Participants were on average 55.5 years of age and 58.1 % were female. Two groups based on the activation level were created: 270 (6 %) had low activation, and 4262 had high activation. The low activation level was associated with the likelihood of delayed discharge (odds ratio [OR] 1.47, 95 % CI, 1.11–1.95; P = .008), higher symptom burden (OR 1.99, 95 % CI 1.49–2.66, P 
ISSN:0020-7489
1873-491X
DOI:10.1016/j.ijnurstu.2024.104751