Tavernier et al reported criteria for early discharge after laparoscopic colorectal surgery. The authors are from Lyon Sud University Hospital, Tulane University, and Lyon University.
Patient selection: status post laparoscopic colorectal surgery
Outcome: A successful discharge was a discharge on postoperative day 2 or 3 without 30-day readmission or complication. A key cause of failed early discharge is an anastomotic leak.
NOTE: The paper reports a cutoff of 150 mg/dL. This is a high number, equivalent to 1500 mg/L. The authors cite a source (Ortega-Deballon et al) for the cutoff which used mg/L.
Criteria - all of the following:
(1) serum CRP < 150 mg/L on the day of discharge
(2) return of bowel function
(3) able to tolerate a diet
(4) pain less than 5 on a 10 cm VAS scale
(5) afebrile during the entire hospital stay
where:
• It is assumed that the patient is not on receiving an antipyretic.
Performance:
• The negative predictive value of all 5 criteria being met was 0.984.
