Factors Contributing to Delayed Discharge Related to Stoma Education in Patients Undergoing Colorectal Surgery: A Retrospective Analysis

Abstract

Stoma formation often delays discharge after colorectal surgery, heightening the risk of hospital-acquired infections, financial burdens, and reduced hospital capacity. Enhanced Recovery After Surgery (ERAS) protocols aim to mitigate these issues by emphasizing early stoma management education; however, specific causes for delayed discharge related to stoma education remain underexplored. A retrospective review of patients undergoing colorectal resection with stoma formation at a single tertiary institution between 2019 and 2023 was conducted. The primary objective was to identify factors contributing to delayed discharge related to stoma formation and education. A secondary objective was to assess the financial impact of these delays. Among 159 patients who underwent colorectal resection with stoma formation, 31 patients experienced discharge delays with a mean of 2.8 days (95% CI: 1.4-4.2 days). The primary reason for the delay was the lack of ostomy teaching availability on weekends in 21 patients (64.5%), followed by patient-related challenges in three patients (9.6%), suboptimal stoma positioning in two cases, and unavailability of stoma appliances in two cases. The delays incurred an estimated additional cost of $406 224 for 31 patients over 5 years. The unavailability of stoma education on weekends is the primary contributor to delayed discharge; underscoring the need for improved access to educational resources to facilitate timely discharge.