Hospital Stay and Mortality Are Increased in Patients.pdf


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PERIOPERATIVE MEDICINE

Table 2. Model of Excess Length of Stay
Model Variable

Hazard Ratio (95% CI)

Significance
⬍0.001

MAP/BIS/MAC state
REF
High/High/Low
Low/High/High
High/Low/High
Low/High/Low
High/Low/Low
Low/Low/High
High/High/High
Low/Low/Low
Age
ⱕ40 yr (reference)
41–50 yr
51–60 yr
61–70 yr
71–80 yr
ⱖ81 yr
Gender
Male (reference)
Female
Race
White (reference)
African-American
Other
BMI (kg/m2)
ASA Physical Status
1 and 2 (reference)
3, 4, and 5
N2O administered?
No (reference)
Yes
Mean propofol rate (g/h)
Case duration (min)
Maintenance agent
Isoflurane (reference)
Sevoflurane
Desflurane
RSI (length of stay); total procedure risk
Lowest quintile (reference)
Second quintile
Third quintile
Fourth quintile
Highest quintile
RSI (length of stay); total cancer risk
Lowest quintile (reference)
Second through fourth quintiles*
Highest quintile
RSI (length of stay); total noncancer risk
Lowest quintile (reference)
Second quintile
Third quintile
Fourth quintile
Highest quintile

1.0
1.110 (0.950–1.296)
0.969 (0.850–1.104)
0.950 (0.849–1.063)
1.139 (1.001–1.297)
1.208 (1.047–1.394)
1.078 (0.941–1.236)
0.903 (0.791–1.030)
1.470 (1.268–1.704)
1.0
1.006 (0.888–1.141)
1.044 (0.928–1.174)
1.106 (0.980–1.248)
1.326 (1.160–1.516)
1.512 (1.276–1.792)
1.0
1.147 (1.069–1.230)

0.188
0.632
0.370
0.050
0.009
0.278
0.129
⬍0.001
⬍0.001
0.922
0.476
0.101
⬍0.001
⬍0.001
⬍0.001
⬍0.001

1.0
1.381 (1.244–1.533)
1.211 (1.013–1.448)
1.011 (1.007–1.015)

⬍0.001
0.035
⬍0.001

1.0
1.237 (1.142–1.340)

⬍0.001

1.0
1.171 (1.087–1.262)
0.977 (0.964–0.990)
1.099 (1.079–1.120)
1.0
1.090 (1.002–1.186)
0.955 (0.871–1.048)
1.0
0.731 (0.666–0.803)
0.631 (0.568–0.702)
0.487 (0.435–0.544)
0.512 (0.440–0.596)
1.0
1.274 (1.168–1.391)
2.135 (1.585–2.877)
1.0
0.443 (0.402–0.489)
0.384 (0.345–0.427)
0.378 (0.337–0.424)
0.484 (0.430–0.543)

0.001
⬍0.001
⬍0.001
0.007
0.044
0.332
⬍0.001
⬍0.001
⬍0.001
⬍0.001
⬍0.001
⬍0.001
⬍0.001
⬍0.001
⬍0.001
⬍0.001
⬍0.001
⬍0.001
⬍0.001

* Quintiles containing identical values were pooled.
ASA ⫽ American Society of Anesthesiologists; BIS ⫽ Bispectral Index; BMI ⫽ body mass index; MAC ⫽ minimum alveolar
concentration; MAP ⫽ mean arterial pressure; N2O ⫽ nitrous oxide; REF ⫽ reference group; RSI ⫽ risk stratification index.

The fraction of patients requiring hospitalization for
longer than the national average for a given procedure
(i.e., excess length of stay) increased significantly as the
duration of triple low minutes increased and was signifiAnesthesiology 2012; 116:1195–203

cantly greater than baseline (no triple low minutes) at
all times exceeding 30 min (fig. 4). Inclusion of nitrous
oxide use in the statistical model did not substantively
alter the results.
1199

Sessler et al.