Predictors of complications and hospital stay in gynecologic cancer surgery

Objective: To test the hypothesis that comorbid medical conditions can pred ict length of hospital stay and incidence of postoperative complications. Methods: We reviewed the medical records of 187 women who had surgery for k nown or suspected gynecologic malignancies during 1996 and 1997, and 179 we re included in the present study. Information on each woman's comorbid medi cal conditions, surgical history, surgicopathologic cancer diagnosis, Ameri can Society of Anesthesiologists' classification, surgical procedures, and postoperative complications was collected and analyzed. Results: Women with two or more comorbid medical conditions had significant ly longer mean hospital stays (8.62 days) than those with none or one comor bid medical condition (6.43 days) (P <.001). Women with two or more postope rative complications had significantly longer mean hospital stays (11.88 da ys) than those with none or one complication (6.02 days) (P <.001). Women w ith two or more postoperative complications also had significantly more com orbid medical conditions (mean 2.5) than those with none or one complicatio n (mean 1.7) (P <.001). The American Society of Anesthesiologists class als o was a significant predictor of postoperative complications and length of hospitalization. Age over 60 years also was associated with statistically s ignificant increase in comorbid medical conditions and significantly longer hospitalizations. Conclusion: Our findings indicated that certain high-risk patients can be i dentified before hospital admission based on comorbid medical conditions. C ertain risk indices, such as the American Society of Anesthesiologists clas sification score, also can predict postoperative complications and length o f hospital stay. This information can be used to coordinate preoperative an d postoperative hospital care and be a reference for certain future disease management systems. [Obstet Gynecol 2001;97:721-4. (C) 2001 by The America n College of Obstetricians and Gynecologists.).