Premium
The impact of intensive care unit stay following oesophagectomy for oesophageal cancer on long‐term survival
Author(s) -
Askari Alan,
Wong Joshua,
Rabinowitz Josh,
Riaz Amjid
Publication year - 2021
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12510
Subject(s) - medicine , interquartile range , hazard ratio , intensive care unit , esophagectomy , confidence interval , proportional hazards model , survival analysis , survival rate , surgery , stage (stratigraphy) , esophageal cancer , cancer , paleontology , biology
Abstract Aim Survival in patients with oesophageal cancer is associated with an overall poor 5‐year survival rate. The aim of this study was to determine whether return to theatre, overall and intensive care unit (ICU) length of stay (LOS) impact long‐term survival. Methods A single‐institution dataset of prospectively collated data from January 2011 to December 2018 were analysed. Survival analysis using multivariable Cox regression analyses were undertaken to determine factors associated with survival. Results A total of 190 patients underwent an oesophagectomy, of whom 81.6% (155/190) were male and the median age was 66 years (interquartile range 58‐72 years). The median length of stay was 12 days (interquartile range 10‐15 days). At a mean follow‐up of 36 months, 41.9% (117/279) of the population were deceased. Nodal, N3 staging [hazard ratio (HR) 5.30, 95% confidence interval (CI) 2.92‐9.63] was associated with poorer survival. Prolonged ICU stay of 5 to 7 days (HR 2.26, 95% CI 1.18‐4.33, P = .015), 8 to 10 days (HR 3.96, 95% CI 1.65‐9.50, P = .002) and over 10 days (HR 2.47, 95% CI 1.11‐5.47, P = .027) was also associated with significantly worse survival. Conclusion Prolonged ICU stay after oesophagectomy has a negative impact on survival irrespective of the tumour stage. Enhanced recovery programs aimed at fast‐tracking ICU care and early safe patient discharge may improve long‐term survival.