{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:54:18Z","timestamp":1747184058865,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,10]],"date-time":"2021-01-10T00:00:00Z","timestamp":1610236800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Despite the financial and value\u2010based implications associated with higher levels of care at discharge, few studies have evaluated modifiable treatment factors that may optimize postacute care. The aim of this work was to assess the association between operative approach and disposition to a higher level of care and other outcomes following surgery for rectal prolapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Using a retrospective cohort study design, the database of the National Surgical Quality Improvement Program was used to identify patients with rectal prolapse who underwent perineal repair or open or laparoscopic rectopexy with or without resection between 2012 and 2017. Discharge destination and 30\u2010day postoperative outcomes were compared using propensity score mathcing and weighting. Nomograms generated using multivariable regression calculated the risk of requiring higher levels of care upon discharge and morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Propensity\u2010score analysis included 3000 patients [1500 in the perineal group, 580 in the open abdominal group and 920 in the minimally invasive (MIS) group]. Patients who received open abdominal surgery were more likely to require elevation of care at destination compared with those who received perineal surgery (OR 1.65, 95% CI 1.22\u20131.24) and MIS abdominal surgery (OR 1.80, 95% CI 1.18\u20132.76). Similar effects were seen for overall morbidity. Increased age, higher American Society of Anesthesiologists class, congestive heart failure, dependent functional status and open surgery were independent predictors of discharge to higher level of care (<jats:italic>c<\/jats:italic>\u2010statistic\u00a0=\u00a00.79).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Open surgery compared with MIS and perineal surgery was associated with higher levels of discharge disposition following rectal prolapse surgery. Future research should continue to identify modifiable treatment factors that reduce poor postoperative outcomes among patients with rectal prolapse.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15466","type":"journal-article","created":{"date-parts":[[2020,11,28]],"date-time":"2020-11-28T20:23:38Z","timestamp":1606595018000},"page":"955-966","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["I want to go home: should we abandon open surgery for treatment of rectal prolapse? Consideration of discharge destination following surgery for rectal prolapse"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3162-8960","authenticated-orcid":false,"given":"Sarah B.","family":"Jochum","sequence":"first","affiliation":[{"name":"Department of Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adan Z.","family":"Becerra","sequence":"additional","affiliation":[{"name":"Department of Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Rush Bioinformatics and Biostatistics Core Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos A. Q.","family":"Santos","sequence":"additional","affiliation":[{"name":"Rush Bioinformatics and Biostatistics Core Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana M.","family":"Hayden","sequence":"additional","affiliation":[{"name":"Department of Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodore J.","family":"Saclarides","sequence":"additional","affiliation":[{"name":"Department of Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuradha R.","family":"Bhama","sequence":"additional","affiliation":[{"name":"Department of Surgery Rush University Medical Center Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,10]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234167"},{"key":"e_1_2_17_3_1","first-page":"63","article-title":"Surgical management of rectal prolapse","volume":"140","author":"Marderstein EL","year":"2007","journal-title":"Nat Clin Pract Gastroenterol Hepatol"},{"key":"e_1_2_17_4_1","first-page":"CD001758","article-title":"Surgery for complete (full\u2010thickness) rectal prolapse in adults","volume":"2015","author":"Tou S","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_17_5_1","first-page":"CD001758","article-title":"Surgery for complete rectal prolapse in adults","author":"Tou S","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_17_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12177"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.07.004"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31826ab5e6"},{"key":"e_1_2_17_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481307900712"},{"key":"e_1_2_17_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-014-3707-3"},{"key":"e_1_2_17_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.02.010"},{"key":"e_1_2_17_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(99)00191-X"},{"key":"e_1_2_17_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2009.00968.x"},{"key":"e_1_2_17_14_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.0668"},{"key":"e_1_2_17_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.21884"},{"key":"e_1_2_17_16_1","unstructured":"GreiferN.WeightIt: weighting for covariate balance in observational studies. 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