Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.
Safety of hospital discharge before return of bowel function after elective colorectal surgery / J Chapman, S; Blanco-Colino, R; Pérez-Ajates, S; Anabitarte Bautista, O; Hodson, J; Blanco-Colino, R; J Chapman, S; C Glasbey, J; Pata, F; Pellino, G; Sgrò, A; Soares, A; van Elst, T; Van Straten, S; Nepogodiev, D; Hodson, J; Borakati, A; F Bath, M; H Yasin, I; Mclean, K; Arthur, T; Kovacevic, M; Delibegovic, S; Karamanliev, M; Swamad, M; Žebrák, R; Paramasivam, R; Martensen, A; M Larsen, H; Rädeker, L; E Frey, P; Kechagias, A; Venara, A; Duchalais, E; Ioannidis, A; Pata, F; Pellino, G; Pasquali, S; Sgrò, A; Simioni, A; Farina, V; Podda, M; Lorenzon, L; Schaeff, V; Otto, A; Jakubauskas, M; R van Elst, T; Chu, M; Fagan, Pvb; I Wells, C; Alagoa João, A; Soares, A; Juloski, J; Blanco-Colino, R; Pérez-Ajates, S; Anabitarte Bautista, O; El Kasmy El Kasmi, Y; Espin-Basany, E; Clerc, D; Ciubotaru, C; Popescu, S; Yanishev, A; Lee, S; B Ozkan, B; Yagız Sen, A; K Aktas, M; E Baki, B; Yüksek, B; C Glasbey, J; Kamarajah, S; Mclean, K; Borakati, A; H Yasin, I; A Khaw, R; Mills, E; Goodson, R; Thakral, N; D Ablett, A; Adra, M; Kwek, I; M Khan, S; Quinn, P; R Manley, L; Badran, A; Ramjeeawon, A; Campbell, A; L Tan, H; S Rye, D; Rajaraman, N; G Norman, J; Vutipongsatorn, K; Solomou, G; Akhbari, M; Ali, A; Murray, V; M Baker, D; D Brandao, B; Stainer, B; Thavayogan, R; Jones, D; O Onafowokan, O; Gharooni, A; Dabab, N; Carlton-Carew, S; Kungwengwe, G; Gabriel, M; Sewart, E; C Shortland, T; Lawday, S; Pockney, P; Dawson, A; Arthur, T; D Brumfitt, C; Stewart, P; Ng, B; K Luong, J; Delibegovic, S; Ivanov, V; Borisova, A; Neykov, V; Kunčarová, K; Kološová, B; Antonova, T; Farkašová, M; Žebrák, R; L Harbjerg, J; Brandsborg, S; Brinck, S; D Kjaer, M; Mark-Christensen, A; P Unbehaun, K; Dalsgaard, P; D Lycke, K; Kechagias, A; Lenaoures, P; Duchalais, E; Brigand, C; Dumange, E; Gout, M; Moehwald, C; Prem, M; Alhalabi, O; Sliwinski, S; Krupp, J; Gablenz, E; Schmitzer, L; Kopp, A; Steinle, J; Gsenger, J; J Pohl, L; Riccardi, M; M Christodoulou, I; Konstantinidis, M; Machairas, N; Zoikas, A; Balalis, D; K Manatakis, D; L Aguilera, M; Sgrò, A; Simioni, A; Marano, L; Fleres, F; Lovisetto, F; Sasia, D; Segalini, E; Pata, G; Lucchi, A; Sagnotta, A; Campagnaro, T; Petrelli, F; Gallo, G; Papandrea, M; Testa, V; Sinibaldi, G; Di Candido, F; Colombo, F; Perrone, G; Aresu, S; Biancafarina, A; Canonico, G; Pagnanelli, M; Curletti, G; Bini, R; de Manzoni Garberini, A; Impellizzeri, H; Cillara, N; Tutino, R; Picciariello, A; Coletta, D; Savino, G; Ferrara, F; Tamini, N; Talamo, G; Parini, D; Giamundo, P; Lo Conte, A; Pagano, G; Ripetti, V; Pesce, A; Menduni, N; Pellino, G; Giudicissi, R; Podda, M; Goldin, E; Rega, D; Belli, A; Andriola, V; Gordini, L; Pata, F; Foppa, C; Piccolo, G; Birindelli, A; Ferrari, C; Ballarini, Z; Tirelli, F; Milone, M; De Rosa, M; S Pipitone Federico, N; Molteni, B; L Tilocca, P; Sancini, G; N Piozzi, G; Lauretta, A; Poillucci, G; Mulas, S; Schaeff, V; Otto, A; Jakubauskas, M; Simcikas, D; Portelli, L; van Wijnbergen, Jwm; L Dinger, T; Ten Doesschate, Sfh; van Dalen, Ashm; D van den Bos, D; Hansmann, M; Medina Feliz, J; Z Kuiper, S; Abdulrahman, Z; R Pruijssers, S; Farik, S; M Elliott, B; P Geneta, V; Chu, M; Wilton, S; Kandelaki, H; L Peng, S; Campbell, S; K Lim, Y; S Yassaie, S; Murray, M; Fagan, Pvb; Haran, C; Tan, J; Castro, J; Laranjeira, A; Catarino, S; Neves-Marques, C; G Correia, J; N Vieira, B; C Quintela, A; L Serra, M; Maciel, J; Cunha, M; J Aparício, D; Neves, J; Azevedo, J; Romano, M; Eiró, F; Romano, J; Monteiro, C; Claro, M; R Almeida, M; Peyroteo, M; D Machado, N; Capote, H; Ferreira, M; Sousa, X; Devesa, H; Cavadas, D; Guerreiro, I; Costa, M; Rosete, M; Salman, M; English, C; Mohammed, N; Popescu, S; Yanishev, A; Litvin, A; V Ćuk, V; Mészárosová, K; Van Straten, S; Jaich, R; De Lima, H; Brooks, S; Marx, M; Nshalati Salvation, M; García Cardo, J; Mora-Guzmán, I; Sancho Muriel, J; de Andres Olabarria, U; Muriel, P; Jimenez Viñas, C; Alconchel, F; Esteban Sinovas, O; El Kasmy El Kasmi, Y; Fairén Oro, C; Pérez-Ajates, S; López Otero, M; Figueroa Jiménez, S; Claramonte Bellmunt, O; Martínez Caballero, J; Rubio-Pérez, I; M Aguilar-Martínez, M; J Segura-Sampedro, J; Olmedo Moreno, C; Negre Parra, D; M Estévez Diz, A; Martín-Balbuena, R; Bustamante Recuenco, C; E Licardie Bolaños, R; Fernández, P; Díaz Padillo, A; Forero-Torres, A; Alberdi San Román, I; Salvador Rosés, H; Merayo Álvarez, M; Villarejo Campos, P; C Lopes Moreira, C; Uriol Peralta, P; Serrano Navidad, M; Ripollés-Melchor, J; Garcea, A; Gómez Facundo, H; Anabitarte Bautista, O; Troncoso Pereira, P; V Pérez Guarinos, C; Clerc, D; Blaser, B; Piazza, G; Gagliardi, B; Serin, H; Yagız Sen, A; S Yurdaor, S; K Aktas, M; Arslan, E; Kopac, O; Uyanik, A; B Ozmen, B; Tiftik, E; Aksoy, B; Yalcinkaya, A; Ozoglu, F; D Kocer, M; Bilicen, G; N Cinar, E; Uslu, Ö; Kaya, Y; Demirci, K; Wong, J; Farhan-Alanie, Mmh; Suresh, G; Asif, A; J Finch, B; Bhahirathan, Y; Herron, J; Yi Tew, Z; Obukofe, R; Russell, C; Suchett-Kay, I; Netke, T; Williams, L; Kisiel, A; Y Liu, F; Claireaux, H; James, P; Mondal, A; Kalderon, R; H Nadama, H; Al-Saraff, Z; Tam, Jph; Powell-Chandler, A; Wood, F; Campbell, A; Gorgievska, Rebecca; Ragavoodoo, A; Thakrar, C; Rojoa, D; Palmer, C; Davidson, K; Giacci, L; Hale, J; W Gan, F; Makin-Taylor, R; Y Hey, C; Toh, C; M Findlay, J; Griffiths, N; Ganesananthan, S; Jasionowska, S; Poustie, M; Wong, C; Turner, T; Pyc, W; Sloper, W; Warner, C; Coey, J; Mason, D; Sait, S; Kowal, M; C Shortland, T; Owen, M; Saiyed, A; Ashworth, I; Akbari, K; Curran, M; Martin, P; Parker, D; Dawson, A; Kwok, K; Lye, C; Pockney, P; Ghaly, M; Sammour, T; Lewis, D; Mundasad, R; Wilkes, A; Ctercteko, G; Stewart, P; Delibegovic, S; Maslyankov, S; Dimov, R; Iliev, S; Dimitrov, D; Marek, F; Örhalmi, J; Skalický, P; Skalický, T; Chrz, K; Christensen, P; Worsøe, J; S Kristensen, E; J Emmertsen, K; S Loeve, U; Duchalais, E; L Mihaljevic, A; Herrle, F; M Konstantinidis, K; K Manatakis, D; Korkolis, D; Karanikas, I; L Aguilera, M; Vincenti, L; Anania, G; Borghi, F; Agresta, F; Maretto, I; Parisi, A; Bucci, L; De Palma, G; Guglielmi, A; Cucinotta, E; La Torre, F; Cianchi, F; Guerrieri, M; Lauretta, A; Trompetto, M; Persiani, R; Micheletto, G; Delrio, P; Belli, A; Cantafio, S; Lovisetto, F; Ronconi, M; Bisagni, Pag; De Prizio, M; Tamini, N; Sinibaldi, G; Franceschi, A; Galleano, R; Cavallini, M; Brescia, A; D'Ambra, L; Benevento, A; Niolu, P; Calgaro, M; Colangelo, E; Grottola, T; F Altomare, D; Puleo, S; Salamone, G; Pietrabissa, A; Poggioli, G; Ripetti, V; Erdas, E; Ottonello, R; Canonico, G; Tonini, V; Selvaggi, F; Sammarco, G; Ceccarelli, G; De Nisco, C; Surgo, D; Taglietti, L; Ozolins, A; Sivinš, A; Poskus, T; Psaila, J; A Bemelman, W; J Graat, L; Langenhoff, B; Wijnhoven, Bpl; van de Ven, Ahw; Poelman, M; Stassen, Lps; Slooter, G; Acherman, Yiz; Hoff, C; F Gerhards, M; Stommel, Mwj; J Hazebroek, E; van Geloven, Aaw; A Schasfoort, R; L van Leeuwen, B; B Tuynman, J; van Tilburg, Mwa; G Boerma, E; Sharma, P; Jenkins, B; P Bissett, I; L Peng, S; Herd, A; Gordon, A; Vernon, D; Omundsen, M; Ly, J; Reddy, A; Bonnet, G; Harmston, C; Morales, M; Francisco, V; Costa, S; Manso, A; Amorim, E; Pereira, J; Cardoso, J; Ourô, S; Caratão, M; Nascimento, C; Ribeiro da Silva, B; Taranu, V; Dias, R; Devesa, H; Mendes, J; Allen, M; Silva, A; Carlos, S; Barbosa, E; Carneiro, C; Ramos, L; Maciel, J; Lencastre, L; Martins, R; Silva-Vaz, P; F Ridgway, P; A McNamara, D; Cahill, R; Hogan, A; Larkin, J; R O'Connell, P; Negoi, I; Abelevich, A; M Ćuk, V; Vician, M; Ede, C; Sardiwalla, I; Mulira, S; Montwedi, D; Oyomno, M; Sabia, D; Portugal Porras, V; Vigorita, V; Sanz Ortega, G; García, J; Espí Macías, A; Blanco Antona, F; A Luján Mompeán, J; Salvans Ruiz, S; Villarejo-Campos, P; Romero Simó, M; Sánchez-Guillén, L; M Jiménez-Gómez, L; Sánchez López, A; Golda, T; Julià Bergkvist, D; Nevado, C; F Noguera Aguilar, J; Ricardo Felipe, B; Septiem, J; Rodríguez Sánchez, A; Cañete-Gómez, J; Ruiz Montesinos, I; Ripollés-Melchor, J; Millán-Scheiding, M; Prieto-Nieto, I; J Segura-Sampedro, J; Espin-Basany, E; Frasson, M; Alberdi San Román, I; García Olmo, D; Hübner, M; Petermann, D; O Sauvain, M; Ozben, V; E Geçim, I; Disçi, E; Rencuzogullari, A; Kurt, A; Bisgin, T; Pehlivan, M; Isik, A; Onur, E; Leventoglu, S; C Haksal, M; S Erturk, M; Keskin, M; Guner, A; Tutcu Sahin, S; S Ozbalci, G; Pergel, A; Albayrak, D; Bruce, D; Fearnhead, N; Arthur, J; Harron, M; Beattie, G; Titu, L; Ali, A; Saunders, M; Phillips, J; Dindyal, S; Cresswell, B; Gercek, Y; Lee, J; Linn, T; Faulkner, G; Lockwood, S; Rees, J; Charalabopoulos, A; Campbell, B; Kontovounisios, C; Amarnath, T; Johnson, M; Epanomeritakis, E; Vigs, S; Nastro, P; Gilliam, A; Smolarek, S; Wilson, T; Orbell, J; Mcintyre, R; Agarwal, T; Hainsworth, P; Patel, P; Vijay, J; Liu, B; Dhruva Rao, P; Roxburgh, C; Vipond, M; Youssef, H; Thorn, C; Schizas, A; Denley, S; Bowley, D; Das, K; Cuming, T; Saha, A; Chung, L; Pitt, J; Davis, P; Jones, O; Taylor, M; Bhargava, A; Haji, A; Watson, N; Bloom, I; Singh, B; Norwood, M; Gurjar, S; Stylianides, N; Mirza, S; Evans, M; Williams, G; Patil, P; Hernon, J; Finch, G; Green, S; Chapple, K; Fafemi, O; Warusavitarne, J; Samee, A; Carden, C; Ong, L; Verma, K; Joseph, A; Rawat, N; Pinkney, T; Oke, O; Glen, P; Maxwell-Armstrong, C; Oliphant, R; Garner, J; J Moug, S; Middleton, S; N Lund, J; J Smart, N; Osborn, G; Moore, T; Raymond, T; H Knowles, C; S Hany, T; Clarke, R; Khera, G; Brady, R; Sellahewa, C; Mason, C; Torrance, A; Lasithiotakis, K; Knight, J; Pullybank, A; Ainsworth, P; Reid, F; Ramwell, A; Maslekar, S; George, R; Skull, A; Holtham, S; Muhammad, K; Lal, R; Varcada, M; M Smith, F; Howlader, M; Defriend, D; Kirk, S; Richards, T; Evans, C; M Borg, C; Telford, K; Sarfraz, N; Busby, K; Hollingshead, J; Speake, D; Pawa, N; West, D; Chadwick, M; Komolafe, O; Richardson, S; Thornton, M; Goede, A; Osborne, C; Bandyopadhyay, D; Foong, J; J Lee, Y; Liebenberg, P; Mijalkov, D; Wells, A; Bull, N; Ajmera, A; Warburton, T; Morgan, S; Mahmoud, A; Schachtel, M; Mikhail, B; Fomin, I; Mekaeil, B; Taylor, N; Stevenson, C; Drane, A; Pahalawatta, U; T Lai, L; Debiasio, A; Wong, J; Jun, Hjs; Hengpoonthana, R; M Mendis, D; M Robb, P; J Lee, H; Wyche, Aab; T Davis, L; J Lee, H; Chrimes, A; Agarwal, A; Zhao, J; Williams, S; Jayalath, Jmsn; Liebenberg, P; Khor, S; Muddasani, T; Childs, S; Ridgway, S; Blefari, Nda; Tam, H; Puchalski, N; Ngai, C; Mackenzie, J; Johnson, N; Holmes, M; Zuzek, R; Saluja, T; Gould, T; K Goh, Y; Selvaraj, T; D Brumfitt, C; Z Beh, Y; N Dudi-Venkata, N; Horne, D; L Borrow, J; Campbell, C; Cousins, G; Jackson, L; Maheepala, K; Zhao, S; Holden, E; Tutt, L; Thompson, B; Collins, H; Louie, F; Buckland, B; Smith, D; Chong, C; H Chua, T; Nayak, C; Redmond, J; R Tan, R; Gramlick, M; S Teh, J; Y Ng, S; Britten-Jones, P; Mohd Rosli, R; Pham, Hdv; Jegathees, T; Coulter-Nile, Smcj; P Gosselink, M; K Luong, J; L Wang, Y; Maciaszek, M; S Chrapko, P; Nair, A; Thirugnanasundralingam, V; Muir, K; Salibasic, M; Pavlov, V; Paycheva, T; Borisova, A; Lyulenina, E; Kolev, N; Ivanov, V; Nguen, D; Mitkov, Y; Mitkov, E; Vladova, P; Dimitrov, V; Hussain, M; Gabarski, A; Ivanov, T; Yotsov, T; Ilieva, I; Karamanliev, M; Akisheva, A; Shoshkova, M; Nawaz, E; Feradova, H; Mladenov, T; Neykov, V; Jozaf, V; Farkašová, M; Klail, T; Pös, M; Adel, A; Sotona, O; Bartoš, M; Amjad, T; Malý, O; Berec, S; Hanušová, M; Hurný, M; Riško, J; Ludvik, M; Stercz, M; Treskoň, R; Pospíšil, M; Hlaváčová, L; Kunčarová, K; Tomanová, D; Chodora, S; Houdek, O; Novický, R; Antonova, T; Sobotková, K; Cha, S; Šuta Kimle, K; Jirankova, K; Bujda, M; Paclík, A; Trap, A; Jürgens-Lahnstein, J; Storm, M; Dalsgaard, P; Damgaard, I; Olawi, F; Ehlern, F; Raos, M; P Kristensen, F; D Lycke, K; Bønnerup, K; P Unbehaun, K; D Kjaer, M; Brandsborg, S; Amiri, S; Enevoldsen, M; L Harbjerg, J; Højgaard Pedersen, J; N Jepsen, B; K Hillgaard, T; B Erichsen, S; V Nielsen, C; P Madsen, C; Bjerke, J; D Skejø, C; R Aabling, R; S Sørensen, J; Mark-Christensen, A; Kechagias, A; Turunen, A; Katunin, J; Niskakangas, M; Vignaud, T; Frey, S; Ricolleau, C; Chanut, F; Magnin, J; Gout, M; Seiboldt, T; Beck, L; J Pohl, L; Zamzow, K; Betge, F; Poncelet, A; Truant, M; Hauschild, H; Neugebauer, N; Schöning, L; Cs Simon, S; Galata, C; Karampinis, I; Thäwel, T; M Seckler, A; Kerem, C; Durdevic, S; Ioannidis, A; Antonakopoulos, F; Konstantinidis, M; Mathioulaki, A; Chrysoheris, P; G Athanasopoulos, P; Kalles, V; Spyrou, I; Barkolias, C; Paspala, A; Machairas, N; Papaconstantinou, D; Spartalis, E; Arkadopoulos, N; Prodromidou, A; Garoufalia, Z; Balalis, D; Zoikas, A; M Christodoulou, I; Mendez, D; Rosales, J; Flores, M; Garcia, M; Garcia, A; Garcia, M; Noriega, Z; Torselli, D; L Aguilera, M; Rodriguez, J; Lafranceschina, S; Artioli, E; Giaccari, S; Nevoso, V; Schimera, A; Marino, S; Geretto, P; Pellegrino, L; Borghi, B; Sasia, D; Marano, A; Corino, C; Cannata, G; C Giuffrida, M; Landra, F; Pata, G; Ongaro, D; Baronio, G; Raimondo, S; Casiraghi, S; Salvadori, R; Savino, G; Finotti, E; Ciccioli, E; Galgano, A; Zuin, M; Simioni, A; Bettella, A; Barina, A; Vendramin, E; Palano, G; Schiavone, D; Di Cintio, A; Gemini, A; Trastulli, S; De Luca, M; Sagnotta, A; Desiderio, J; Gubbiotti, F; Cigognini, M; Zaffaroni, G; Maffioli, A; Colombo, S; Bondurri, A; Sampietro, G; Foschi, D; Colombo, F; Manigrasso, M; Danzi, M; Amato, R; Anastasio, L; Mastella, F; Basile, R; Peltrini, R; Marra, E; Luglio, G; Pagano, G; Giglio, M; Manigrasso, M; Anoldo, P; Vertaldi, S; Grimaldi, L; Tammaro, N; Pedrazzani, C; Campagnaro, T; Turri, G; Lazzarini, E; Conti, C; Vulcano, I; Bertilone, E; Pintabona, G; Viscosi, F; Cerasari, S; Galiffa, G; Lapolla, P; Coletta, D; Del Basso, C; Cirillo, B; De Toma, G; Fazzi, K; Bini, S; Coratti, F; Montanelli, P; Grandi, S; Nelli, T; Ben Khaled, N; Cammelli, F; Ferrini, E; E Billo, M; L Tilocca, P; G Marrosu, A; Scognamillo, F; Pala, C; Attene, F; Carboni, L; W Ruggiu, M; Gabbas, G; Marziali, I; Mazzocato, S; Petrelli, F; Vergari, R; Piazzai, F; Kubolli, I; Aggiusti, A; Paolucci, A; Ortenzi, M; Olivieri, M; Belluco, C; D Antona, A; Basso, S; Morino, M; Mistrangelo, M; Testa, V; Gallo, G; Clerico, G; De Santi, G; F Bitonti, M; Trompetto, M; S Pipitone Federico, N; Frattalone, M; Tirelli, F; Fico, V; Santullo, F; Belia, F; Spinelli, A; Marco, M; Di Candido, F; Bevilacqua, M; Tringali, D; Bevilacqua, E; Panizzo, V; N Piozzi, G; La Manna, V; Migliore, G; Aversano, A; Fares Bucci, A; Marino, F; Carbone, F; Incollingo, P; M Romano, F; Giudicissi, R; Zalla, T; Baraghini, M; Romoli, L; Calussi, M; Vellei, S; Genzano, C; Feroci, F; Vita, M; Barberis, A; Serra, D; Lucchi, A; Grassia, M; Romelli, M; Ruggiero, S; Percassi, A; Ferrari, C; Molteni, B; Magri Piccinini, A; Segalini, E; Monti, M; Magnoli, M; Romano, S; Gaetano, P; Pilotta, F; Baldassarre, L; Perrone, G; Bonati, E; Aresu, S; Saba, A; Moretto, G; Bacchion, M; Impellizzeri, H; Casaril, A; Inama, M; Creciun, M; Ferrara, F; Stella, M; Gobatti, D; Biancafarina, A; Angelini, M; Andolfi, E; Miranda, E; Scricciolo, M; Provenza, G; Cavallina, G; Frezza, B; Fontani, A; Malatesti, R; A Pellicanò, G; Podda, M; Anania, M; Pulighe, F; Cruccu, A; L Murru, M; Massaiu, C; Balestra, F; Pazzona, M; De Nisco, C; Giannella, A; Santangelo, M; Olivieri, M; Frangella, F; Magagnano, D; Liberatore, P; Brenna, R; Giani, A; Tirotta, F; Famularo, S; Angrisani, M; Ceresoli, M; De Rosa, M; Rondelli, F; Ceccarelli, G; P Angelucci, G; Scaramuzzo, R; Larcinese, A; Fioriti, C; Picone, E; Nardi, M; Marano, L; Castagnoli, G; Bartoli, A; Bellochi, R; Spaziani, A; Conti, D; Poponesi, V; Trippetti, M; Amicucci, S; Tazza, G; Procacci, P; Giovannini, F; Basile, E; Franceschi, A; Caristo, G; Pagnanelli, M; De Nardi, P; Rosati, R; Marcocci, G; Vignali, A; Curletti, G; Galleano, R; Badran, A; Malerba, M; Percivale, A; Ghazouani, O; Reggiani, L; Spirito, C; Moschetta, G; Cosmi, F; Romeo, G; Gasparrini, M; Sucameli, F; Gennai, A; Moggia, E; Bianchi, C; Bonfante, P; Macina, S; Feleppa, C; Talamo, G; Imperatore, M; M Tenconi, S; Rausei, S; Maioli, D; Marchionini, V; Pata, F; Sparta, C; A Mura, F; Barmina, M; Lorettu, A; Rettaroli, C; Mastino, G; V Ruggiu, G; A Mura, G; A Perrone, B; De Angelis, M; Mereu, A; Adamo, V; Bianco, C; de Manzoni Garberini, A; Ricciardiello, M; Campanaro, C; Panaccio, P; M Esposito, L; D'Ascanio, F; Pietroletti, R; Picciariello, A; Chetta, N; Aquilino, F; Di Marco, F; Amico, A; Schembari, E; Puglisi, S; Licari, L; Campanella, S; Profita, G; Falco, N; Rotolo, G; Venturelli, P; Tutino, R; De Marco, P; Marcianò, M; Sgrò, A; Argenti, F; S Milani, M; Malabarba, S; Giambartolomei, G; Vella, I; Gronchi, F; Ruggieri, A; Sancini, G; Roggiani, A; Balsamo, F; Gori, A; Cuicchi, D; D'Alessio, R; Benvenuto, D; Gordini, L; Erdas, E; Podda, F; Cappellacci, F; Salaris, C; Sanna, S; Marcialis, J; Mosino, L; Peddis, M; Melis, S; De Donno, G; C Aru, A; Falsetti, E; Parini, D; Lanari, J; D'Errico, U; Bianchini, S; Birindelli, A; Figà, F; Caiazzo, A; Selvaggi, L; Capozzolo, A; Cerra, C; Pirillo, M; Papandrea, M; Cravano, S; Libri, I; Laquatra, N; Isabello, A; Truškovs, A; Bartnick, A; Malcevs, E; J Machatschek, M; Alm, J; Lapsa, S; Delorme, M; Zeynalov, F; Larnovskis, J; Sauka, J; Bodrov, D; Gailumsis, R; M Wiemann, A; L Müller, N; Jelovskis, I; Deksnis, D; Bauermeister Potts, O; Slimbajevs, T; E Samalavicius, N; Simcikas, D; Nutautiene, V; Zeromskas, P; Jurgaitis, J; Aliosin, O; Slepavicius, A; Eismontas, V; Kybransiene, M; Dulskas, A; Kuliavas, J; Kavaliauskas, P; Kavaliauskaite, R; Poškus, E; Danys, D; Kryžauskas, M; Mikalauskas, S; Rackauskas, R; Drungilas, M; Poškus, T; Jotautas, V; Strupas, K; Cachia, C; Cefai, C; Portelli, L; Youssef, Y; Degaetano, D; Debono, S; Sammut, M; Cassar, J; Sammut, K; C Looijen, R; van Dalen, Ashm; Becker, Maj; Comert, D; Te Molder, L; Tromp, J; Matthee, E; M Tissen, Y; Brinkhuis, E; S de Vries, H; 't Hart, E; Beckers, K; Bekker, Y; Kakar, S; Ten Doesschate, Sfh; C van Smaalen, T; C Veen, O; A Dingemans, S; C van den Brink, L; Vijgen, Ghej; van de Voort, Emf; van der Pool, A; van Rest, Klc; Haak, T; Sluijpers, Nrf; R Pruijssers, S; Molenaar, Cjl; C Gordinou de Gouberville, M; Saleh, S; A Mens, M; M Hoeks, E; Nieuwenhuizen, S; M van Praag, E; Westerduin, E; Smit, Mpcm; J van der Lely, S; Nasimi, B; Gerdsen, M; Stijns, Rch; Leow, Tys; Penningnieuwland, G; de Ruiter, A; Ribbers, T; Aarts, Cam; S Tulek, M; de Jonge, J; Kocak, S; J Alqethami, H; Constansia, R; C van Elst, P; W Tissink, M; Grüter, A; Vroom, Y; M Voeten, D; Feenstra, T; Azzahhafi, J; Bofarid, S; Kip, M; Saleh, W; Franssen, S; L Boon, C; Franssen, Rjm; Romaen, I; Jense, Mtf; D'Souza, J; Pascoe, R; Scott, A; Stark, E; Mulholland, K; K Lau, W; Smith, B; Adams, Sib; Shah, N; Ling, E; Young, J; L Peng, S; Jacobson, A; Macfater, H; Farik, S; Y Chen, S; Kilpatrick, K; H Kim, D; Dixon, S; Yassaie, S; Welman, D; Coulter, J; Morreau, M; Li, E; Rankin, A; Winders, J; Skipworth, C; Fagan, Pvb; Stanfield, B; Henderson, N; Chuang, A; Maskill, L; Ker, H; Mclaughlin, Sjp; Kearney, J; Wilton, S; Sprosen, H; Kerckhoffs, P; Alsadat, R; Cherry, R; A Chapman, D; Singh, N; Clucas, A; Gatenby, G; Kelly, B; Ruppeldt, P; D McIntosh, N; Koh, S; Wilms, H; Dalzell, F; Tewhaiti-Smith, J; Kader, T; T Yam, S; Dahya, D; Hardie Boys, M; Fleischl, W; Tan, J; Skavysh, A; Mouldey, K; M Elliott, B; Hu, R; Edwards, S; Matthews, C; Aitken, E; Walker, M; Guerreiro, I; Tomé, M; Patrocinio, S; Amado, F; Batista, A; Seabra, J; Praxedes, V; Monteiro, N; Martins, I; L Serra, M; C Santos, T; R Lages, R; Pimentel, A; D Machado, N; C Sá, T; M Bernardes, F; Saraiva, P; Almeida, J; Mendes, M; Fernandes, V; Ribeiro, A; Soares, D; Costa, M; Martins, T; Miguel, I; Martins, J; F Cunha, M; Melo, J; N Veiga, D; Rachadell, J; Rachadell, J; Amorim, E; Vareda, R; Roseira, J; Catarino, S; Aveiro, D; Couto, M; R Loureiro, A; Louro, H; Queiros, T; Castro, B; Fonseca, S; Carvalho, L; P Torre, A; Amado, A; Leite, M; Miranda, P; Cunha, C; Ferreira, M; Cavadas, D; Silva, R; Pina, S; Paixão, I; Orelhas, L; Santos, J; Pacheco, A; F Rocha, A; J Jervis, M; Pedro, V; Paixão, V; Guerreiro, A; Melo, D; Correia, D; Capella, V; Moinhos, T; Monteiro, C; Silva, M; N Vieira, B; G Silva, A; Galvão, D; Mora, A; Bettencourt, R; Costa, F; Gil, I; Morgado, J; Neves, J; Mónica, I; Oliveira, S; Ribeiro, H; Ferreira, M; Guimarães, N; Duarte, M; Miranda, J; F Martins, S; R Almeida, M; Parreira, R; Faustino, A; Medeiros, N; Castro, R; Soares, B; Resendes, M; Almeida, P; Cruz, A; Claro, M; Vaz Pinto, G; Sousa, D; Costa Santos, D; Silva, A; Silva, F; Fialho, G; Reia, M; Pratas, N; Capote, H; Costa, C; Costa, J; Morais, S; Machado, A; Horta, V; Rocha-Melo, M; Patrício, J; Pereira, M; Lima, R; M Cinza, A; Oliveira, J; Velez, C; Ferreira, M; Borges, F; Simões, J; Eiró, F; Botelho, P; Cismasiu, B; Alves, D; Dias, B; Costa, C; P Gonçalves, J; Valente, P; Oliveira, J; Freire, L; Saraiva, R; Moreira, M; Fragoso, M; Guimarães, J; Cruz, G; J Aparício, D; Ribeiro, J; Borges da Ponte, I; Almeida, S; R Martins, A; Louro, T; Morgado, M; S Ferreira, A; Alves, M; Oliveira, N; Lérias, R; Neves-Marques, C; Estalagem, I; Botelho, C; Bártolo, J; Fidalgo Antunes, C; Cabral, F; Brito Silva, F; Dias Matos, A; Santos, M; Cunha, R; Duarte, M; Sousa, M; Canotilho, R; Peyroteo, M; M Correia, A; C Martins, P; Jardim, Jam; P Domingos, S; M Baião, J; S Rocha, B; Lopes, Nmro; M Jordão, D; G Correia, J; D Ângelo, M; Caroço, T; Romano, M; R Gomes, J; G Monteiro, R; Varghese, S; Boyle, E; Aljohmani, L; Alexander, J; Graziadei, V; Mccaughey, C; Jain, A; Lee, J; Ramanayake, H; Sabnani, R; F Colon, L; Bansal, N; Stephens, I; Tan, R; Sharma, S; Doherty, G; Fenn, S; Mulhare, E; Walsh, M; Leavey, C; Costigan, O; Griffin, S; Dockry, É; Khogali, E; K Aly, A; Mcphedran, R; O'Gorman, D; Vermeulen, D; Dervan, L; J Kang, S; Dixon, O; Morrissey, E; Compton, M; R Pentony, A; L Piong, C; Nossier, R; Hanna, J; Sabir, K; Y Eow, S; Ladak, N; Boersma, D; J Kamath, P; Soh, Tbw; H Dyer, A; Y Chee, S; Tan, Ixh; Kelliher, A; Adeusi, L; Howarth, N; Mccawley, N; O'Neill, A; R Jones, M; Saleh, R; Singh, A; Senaratne, R; Kakodkar, P; Balasubramanian, I; Hogan, A; Al-Salihi, A; Vyas, V; Vedadi, A; S Popescu, S; Piras, K; I Ciubotaru, C; Litvin, A; Romanova, E; Ponomarev, N; Savchenko, A; Yanishev, A; Luzan, R; Lutovinova, E; Gavrilina, A; Barkovskaya, A; Kudelkina, N; Topchubaev, D; Radulović, R; Miloševic, K; V Ćuk, V; Bojičić, J; Juloski, J; Genčić, M; Janković, U; Zubowicz, M; K Sucháň, P; Gerstmeier, J; Mészárosová, K; Brazitikou, E; Fytrou, E; Celik, M; Dubovský, M; Schmalenbeck, J; C Sautter, S; Ceyran, H; Jaich, R; Fitchat, N; Mathebula, S; Chauke, J; Mculu, W; Ngwenya, Z; Withey, K; Piperidis, A; Toyi, Y; Nicolaides, A; Jaffer, T; Sparke, A; Van Staden, N; R McDuling, C; Claassen, L; Kruger, C; Weyers, J; Marx, M; Lecler, J; Yebes, A; Anabitarte Bautista, O; C Mana, O; Gomez, H; Riba, L; Perez, J; Casaval Cornejo, L; Vicente Rodríguez, I; Jiménez Escovar, F; de Andres Olabarria, U; Calvo Fernández, M; Portugal Martínez, A; Badiola Bergara, I; Landaluce Olavarria, A; Del Pozo Andrés, E; López Otero, M; Samartín Toimil, C; C Primo Álvarez, J; Rodriguez Fernandez, L; Yebes, A; Ortega, C; E Ossola, M; Camarero, E; Martínez Illán, M; Aranda García, L; Lázaro Cardona, M; Montalvo Olmedo, C; Livianos Arias-Camisón, P; Figueroa Jiménez, S; M Nieto Arranz, J; J Mateos Sexmero, M; Diego Alonso, E; Fairén Oro, C; Izquierdo Moreno, A; Margarida, A; Pando, B; Liquete Marín, L; Pérez Calle, M; J Ramos Cordero, M; Sagredo Cuartango, A; Sánchez, E; Marcos Rodrigo, A; M Martínez Díaz, J; J Ruiz Manzanera, J; Navarro Barrios, Á; Rodríguez Pedreño, L; Alconchel, F; García Moreno, P; García Gómez, M; Rodrigues, K; Platero Diago, J; Veras Lista, M; Rifà Terricabras, S; Butler Sanz, L; Alberch Camprubí, E; Rico Ferrández, M; Puig Lao, E; De Pablo Miró, M; Alberca-Paramo, A; Alia Verdejo, T; Cañete-Manzanares, J; Molina-Florez, M; C García Hernández, L; Orozco Nuñez, S; Suarez-Sanchez, M; Martin-Fernandez, J; M Soriano Liébana, M; Negre Parra, D; F Campo Betancourth, C; Sevila Mico, S; Fernandez, A; Curtis, C; Bosch, M; Triguero, D; Bosch Ramírez, M; Ramayo Díaz, N; González Caraballo, I; Pascual Vicente, T; I Orue-Echebarria, M; Sánchez-Calvo, L; Wang, D; Trueba-Collado, C; T Morales Bernaldo de Quirós, J; Uriol Peralta, P; Lima Pinto, F; O Sullivan, S Núñez; A Ramos Jiménez, F; Alberdi San Román, I; Pérez Ortega, A; Trujillo Barbadillo, A; Romero Pujana, E; V Fernandez Illera, M; Claramonte Bellmunt, O; De La Llave Serralvo, A; Muriel, P; Mestres, N; Cuello, E; Merichal, M; E Sierra, J; Escoll, J; Rufas, M; I Pinillos, A; Ortega, J; Serrano Navidad, M; Vivas Angeles, P; Vives Figueras, R; Baena Sanfeliu, E; Campillo Alonso, B; Alberich Prats, M; Duran Arrocha, J; Cornellà Garceso, N; Uribe Galeano, C; Delisau Puig, O; Castro, A; Salvador Rosés, H; Codony Bassols, C; Fernandes, N; García Ádamez, J; Caula Freixa, C; J Sánchez, M; Martín-Borregón, P; Quevedo, A; Martínez, J; M Marín, J; Rodríguez, P; J Garcia Orozco, J; A Ferrusola Diaz, D; E Licardie Bolaños, R; L Garcia Jimenez, M; Castro Diez, L; Mosquera Fernandez, C; Merayo Alvarez, M; Alonso Batanero, E; Cifrián Canales, I; G Calzada, M; B Recuenco, C; C Martin, M; Esteban Avendaño, I; Jiménez Relimpio, C; Lancho Lavilla, P; Blanco Bartolomé, I; Gómez Cano, I; Blasco Andrés, C; Forero-Torres, A; Alonso-Poza, A; Dieguez, B; Losada, M; Gilsanz, C; García-Vico, A; Roman-Rando, A; Á Sánchez-Gálvez, M; M Bersabe-Alonso, I; Vadillo-Bohorquez, A; D Gutierrez Rios, R; Eizaguirre Ubegun, M; Novo Sukia, I; Uribe Isado, M; Ibañez Alda, M; C Lopes Moreira, C; Olmedo Moreno, C; Pastor Idoate, C; Abad-Motos, A; Marínez-Hurtado, E; Salvachua-Fernández, R; D Padilla Zegarra, E; Franco, M; Martinez, A; Ramos Martin, P; Mate Mate, P; Marcano Chavez, C; Rubio-Perez, I; Ayllon, H; Jerí-McFarlane, S; Soldevila-Verdeguer, C; Pineño-Flores, C; Ambrona-Zafra, D; Fernández-Vega, L; Gil-Catalán, A; Craus-Miguel, A; Pujol-Cano, N; Sena-Ruiz, F; J Gómez Jurado, M; Alberti Delgado, P; Bordanova Reverter, A; Gómez Del Pulgar, A; El Kasmy El Kasmi, Y; F Belzunce-Capó, J; Verdaguer Tremolosa, M; Lin, Q; Muniesa, C; Avelino, L; Cholewa, H; Sancho-Muriel, J; Navasquillo, M; Navío, A; Abelló, D; De Jesus, M; Alvarez, E; Troncoso Pereira, P; M Garcia, J; Gil, A; E Giordano, H; Mignon, G; Vanoni, A; Henkens, A; Jarrar, G; Odovic, M; Willemin, M; Milliet, O; Hahnloser, D; Clerc, D; Demartines, N; Piazza, G; Teixeira, H; Pittet, O; L Haller, M; Gagliardi, B; Huot, A; Blaser, B; Kefleyesus, A; Bugmann, A; M Piotet, L; Meijers, L; K Kurtoglu, G; K Sel, E; C Isler, V; S Yilmaz, B; Adiyaman, C; Kara, M; C Demirkaya, H; K Korkmaz, H; M Pektas, A; Güner, B; C İşlek, E; B Tombul, H; Y Boztuğ, C; Tınaz, A; Yılmaz, M; Karaman, Y; A Akın, F; Dansuk, S; Başçavuş, M; Kaya, M; Kutlu, B; C Seker, M; Erten, V; Memis, U; B Koçak, Z; E Karapinar, Y; Fakirullahoglu, M; Uslu, Ö; Köseoglu, E; Yeni, M; K Aktas, M; Aykun, N; H Agca, M; Bilen, C; Kilinc, I; Atar, C; Kilic, V; Aktuna, C; Aba, M; E Alim, Y; Binbuga, M; Kürklü, Ö; S Yurdaor, S; Ceylan, C; Yilmaz, S; N Çalar, S; Yildirim, N; Yavuz, G; Yagız Sen, A; Can, B; Cesmeli, E; Kus, D; C Kavar, R; D Cevlik, A; Cengiz, U; G Turk, E; Yilmaz, I; Yüksek, B; Erdönmez, H; Gürsoy, F; Serin, H; Kara, H; Önsal, U; Özbek, M; A Kasar, P; Ipor, A; Özen, D; Ölmez, M; Altintas, E; Kaya, Y; Toklu, R; Sariçiçek, T; U Tipi, O; E Benli, G; Tasdelen, I; Tura, A; Ucar, A; Ekci, B; C Bilgili, A; N Kiraz, I; Aksoy, H; N Cinar, E; Basak, A; Erdem, M; Kayacan, S; Sahin, C; Uysal, M; Karakus, K; Altiner, S; S Demirci, Z; Eren, E; Yavas, M; Tiftik, E; B Aksoy, A; Karagöz, E; Sabanci, R; S Tümer, S; Kargici, K; Banaz, T; Abdulrahman, Smf; Yesilsancak, M; Yanikoglu, E; Karabulut, A; Yilmaz, D; F Kuyumcu, O; Kutluk, F; Emiroglu, B; Aksoy, B; Mollavelioglu, B; Gereklioglu, D; Guler, M; Toprak, S; B Afsar, H; E Guler, S; Alizade, E; E Baki, B; Alemdag, G; Ulusahin, M; Arslan, E; B Gul, E; Yildirim, R; Semiz, A; Bektur, G; Tomas, K; Bilicen, G; Yarenci, E; Demiroglu, Y; Sunal, A; Baykan, B; Abbasguliyev, H; Mutlu, V; Mahmoudi, Y; Dossa, Saa; R Mizan, S; Demirtas, B; Cavus, T; Yuksek, A; S Mazlum, S; Yelkenci, C; Baran, T; Satilmisoglu, M; Z Sahin, A; Kilinç, A; Isik, K; Yumurtaci, Ö; Emin, A; Girit, Çagri; K Yildirak, M; Senyigit, E; Güldag, A; Söyleyici, B; E Aytin, Y; E Akay, F; G Iskan, N; Mutlu, B; O Sunay, A; D Ablett, A; Tie-Gill, T; Ramsay, G; De Paola, L; Mcguckin, S; Alshakhs, A; Ahmeidat, A; Wong, J; Goergen, N; Ali, Z; Mullarkey, L; F Bath, M; Walshe, R; Lewis, E; Berry, B; Moneim, J; Mookerjee, S; Christy, S; Ojofeitimi, O; Carroll, L; Hylands, A; P Delaugere, L; Reveendran, D; Coulter, C; Ralston, C; Laverty, L; Gallagher, P; Ahmed, A; Q Yeo, Y; Elliott, D; Bennett, J; Mcnamara, M; Sivarajah, S; Dunmore, C; Aitken, G; Nair, M; H Aly, M; Buari, M; Farhan-Alanie, Mmh; Ahmed, K; Sheikh, Z; Monks, M; Lehmann, J; Rotimi, O; Bell, T; Limnatitou, D; Gormley, S; Taleongpong, P; Patel, V; Macgregor, L; Amini, S; Turner, C; Dwyer-Hemmings, L; Busuttil, A; Powell, J; Hensher, C; Vivian, F; Wcislo, K; Millar, Z; Hirosue, S; Ogunmwonyi, I; Nakakande, D; Kwek, I; Gaze, H; Nirmalanantha, A; A Bin Amran, M; Foulkes, A; Jones, N; Pillai, S; Khoury, G; Powell, T; Maleyko, I; Sangheli, A; Ransome, M; Isse, M; Aromolaran, O; Bholah, H; Anbarasan, J; Rehman, S; Hu, E; Timms, S; Reynolds, W; Hotchkies, A; Misra, V; Suresh, G; Murray, V; Theocharidou, L; Malik, T; Janmohamed, I; Carhart, B; Khan, A; Asif, A; Hullait, R; Quinn, P; Rylance, A; Butt, S; Leathes, J; J Finch, B; Philip Rajathasan, T; Jeddy, H; A Kyaw, H; Wong, N; Karelia, S; M Clements, J; Rainey, M; Joshi, N; Rahman, A; Gallagher, M; Rebuffa, N; Abdelgalil, R; Siaw Yen Lai, R; Laurence, N; Thomas, S; Green, C; Frostick, R; Khera, R; Povey, M; L Wong, H; Mccusker, C; Hlukha, L; Pike, G; Kamel, F; Thakkar, R; Donaldson, C; Sequeira Campos, M; Bhahirathan, Y; N Armitage, M; S Hussain, A; Hardy, B; Y Hassan Serry, M; Herron, J; Bradbury, M; Osunronbi, T; Tam, Lyc; Khanan Kaabneh, A; Lawther, J; Fisher, P; Tribedi, T; Moosa, A; Ramdin, A; Goble, M; Downs, E; Wheldon, L; Baggus, E; Mandal, A; Nayeem, A; Ahmed, S; Fradley, W; Wilson, C; Gallagher, S; Criswell, T; Ward, J; Mukkavilli, A; Stubbs, B; Fordyce, W; Suchdev, N; Wei Lim, S; Yi Tew, Z; R Sookramanien, S; Chan, A; Bointas, G; Paul, M; L Ward, K; Bagnall, M; A Pherwani, S; Wang, K; Mitchell, L; Heyworth, J; Ayyar, S; Obukofe, R; Polson, R; Mason, D; Mackenzie, E; Russell, C; Doyle, N; Habib, Z; Zardab, M; Sartaj, F; Farooq, H; Tabibi, M; J Drury, D; J James, S; Barnett, R; B Teasdale, A; Richardson, Etj; A Thomas, D; Ahmed, S; L Williams, R; F Najabat-Lattif, H; Cahya, E; Lou, G; Coyle, M; Homyer, K; Y Zhu, L; Woods, M; Chang, J; O'Callaghan, H; Suchett-Kaye, I; H Mihailidis, T; Alawattegama, H; Seite, E; Barrett, A; Riordan, E; Lam, W; Dowdeswell, M; Mulvenna, C; Netke, T; Awokoya, O; Gurowich, L; Dhera, K; Hayat, S; Williams, L; Tincknell, L; Spazzapan, M; Teeling, F; Sysum, K; Latter, J; Latter, M; Khan, S; Guruswamy, M; Beedham, W; Brazier, E; Elghobashy, M; Bajaj, M; Mann, H; Etel, E; Woodmass, M; Hayden, H; Kisiel, A; Ali, Y; Husain, S; Arnold, A; C Pedersen, A; Cunha, P; Ahmed, M; Al Zawawi, S; Kudva, V; Y Liu, F; Theodoropoulou, K; Miscampbell, M; V Robinson, A; Johnston, J; Dharni, A; Lamb, S; Westerman, T; Evans, E; Campbell, L; Gillespie, M; M Cheong, C; Kulathevanayagam, K; Varghese, A; I Ike, S; Chu, Tsm; Baljer, B; Mogg, Jaw; Rai, P; A Claireaux, H; Williams, M; Smillie, R; Goetz, J; Appleby, E; Fadipe, T; Vaughan-Burleigh, S; Puri, G; Hussain, P; James, P; Flather, R; Cutler, A; Pathak, S; Sheldon, J; Collicott, T; Al-Ausi, M; Mondal, A; Jovaisaite, A; M Shah, S; Khalid, N; Gutmann, D; Davison, S; J Alame, Y; Syed, L; J Owen, W; D Ahsan, S; Kalderon, R; Anthony-Uzoeto, U; Macleod Hall, C; Zheng, S; Wynter, K; James, C; Sapre, D; Ghosh, R; Baird, J; Cockburn, L; Blackwood, O; H Nadama, H; Simpson, W; Jeong, S; Bishop, S; Bate, R; Hobson, C; H Adam, A; Redclift, C; Do, J; Adeleye, O; Poli, F; Batterham, A; Brown, S; N Parekh, J; Clay, W; Pieri, K; Jackson, A; Brown, S; Saxena, A; Gurung, B; Oyebola, T; O'Brien, F; Djeugam, B; Gardezi, S; Ul-Hasan, S; P Martin-Hernandez, M; Sisley, M; Modi, S; Antakia, R; Elbayouk, A; J Soh, Y; Mather, J; Yusuf, Z; Al-Sarraf, Z; Naja, M; B Rassool, S; Convill, J; Nikookam, Y; Warsame, A; Tam, Jph; Pace, C; Kiandee, M; Ridwan, R; Carey, C; Hirri, F; Mcmillan, Mja; J Ling, J; Powell-Chandler, A; Pendelbury, L; Kerimzade, K; Tang, A; O Howard, E; Humayun, S; J Wadsworth, O; Tan, K; Abdelhameed, F; Haglund, C; Radnaeva, I; Hu, N; Rambhatla, S; Waldron, D; Madahar, P; Malik, S; Campbell, A; C Meney, L; Ibrahim, I; K Kang, C; Chiu, Jzj; Livie, V; Ibrahim, B; Khalil, M; Pooley, G; Shishkin, B; Gorgievska, R; Docherty, J; Southgate, A; Coomes, A; Mcgee, F; Flanagan, S; Thakrar, C; J Tan, Q; Anwar, H; Clough, R; Chrisp, B; Cassels, J; Cross, Gwv; Ragavoodoo, A; Mercer, L; Mercer, C; Refalo, A; Hadley, R; Mctighe, A; Farrow, F; Brodie, A; Davis, G; R Shah, D; Bowers, C; Patel, S; Morice, O; Burzic, A; Cheung, J; Shashidhara, A; Theodoraki, G; Birk, J; Ong, A; Ng, Mpe; Wong, Rtw; Maese, S; Yeap, B; Iqbal, Z; M Rojoa, D; Cabaleiro Barciela, C; Hussain, M; M Ruddy, C; Lindwe, S; Qamar, Y; Chuita, S; Melaugh, T; D Hall, J; Palmer, C; Kouli, O; Hassane, Asi; W Azhar, A; K Tan, T; Perchard, W; Scurr, T; Davidson, K; Campbell, E; Kelk, L; Ghosh, A; Gibbins, A; Mala, D; Loizidou, A; Hall, O; Mecia, L; Hew, C; Varathan, K; Tong, L; Chandrasekar, B; Giacci, L; Buchanan, E; O'Connell, M; Y Kwak, S; H Ong, E; Gardner, S; Lim, J; Maden, C; Illahi, M; Hale, J; Xuan Tan, Z; Edwards, S; Stahl, R; Stahl, J; Hickman, A; Collett, D; Goolam-Mahomed, Z; Allen, B; Atiyah, A; Ahmad, H; Jones, J; Mcgregor, O; Ogundiya, E; W Gan, F; Boulbadaoui, A; Kirnon-Jackman, O; X Lim, Q; Peckham, H; Yeoh, T; Q Yong, S; Y Chen, J; Siva, S; H Sam, Z; Gilani, M; N Goh, Y; G Muthukumar, M; Phillips, S; Makin-Taylor, R; Tjoakarfa, J; Giri, A; Suresan, S; Thavayogan, R; Y Hey, C; Thomas, P; A Johnson, T; I Williams, R; Rashid, A; Kushairi, A; Rais, A; James, A; Bugelli, M; Chechelnitskaya, Y; Sandhu, N; Toh, C; Tandon, R; Gray, M; Kumar, A; Ciurleo, C; Nyamali, I; Hiremath, S; Sinha, S; Chowdhary, M; Bradley, E; Mctiernan, M; Macdonald, S; Sharkey, S; Mclaughlin, N; Amey, C; Kraria, L; Skan, O; Kind, C; M Findlay, J; Tupper, P; Van Rhee, C; I Honeyman, S; Menon, G; Ahmed, M; Jegatheeswaran, L; Griffiths, N; Madhavan, A; Warne, M; L Malcolm, F; Lessware, T; T Wilkerson, H; Chatterjee-Woolman, S; Yoong, A; Ahmed, Wur; Longshaw, A; Flannery, O; Green, R; Leaning, M; Cragg, J; Sharriff, H; Doherty, C; Ganesananthan, S; Kwan, Kwl; Sanders-Crook, L; Bhatia, S; Eames, S; Lewis, F; Kirupananthan, P; Y Boh, Z; Dass, S; Soma, A; Newton, A; Hill, M; Shafiq, Y; Brkljac, M; Boyce, L; Jasionowska, S; J English, W; Lam, S; Chipeta, C; Yilmaz, D; Jain, C; Garofalidou, T; A Novotny, S; Locke, S; Bowman, C; Begaj, A; Murphy, C; Radcliffe, K; T Chong, J; Poustie, M; Jeffrey, E; Chaudhury, N; Rajendran, K; Akbar, Z; Walters, B; Kulendrarajah, B; Tran, N; Shrestha, S; Parmar, S; Gallagher, C; Hennessy, L; Pentti, E; Badhrinarayanan, S; Fung, A; Mansoor, M; Kenny, R; Kan, P; E Lee, D; Khosla, S; Samake, M; Shaban, F; Aftab, R; Gough, M; Woodburn, B; Vayalapra, S; Mcmurrugh, K; Wong, C; Jimulia, D; Deol, S; Pike, S; Embury-Young, Y; Turner, T; Patel, M; Kilgallon, E; Keating, R; Walsh, A; Khan, H; Logue, G; Orekoya, M; Alasmar, M; Charalambides, M; Clavé Llavall, A; Williamson, E; Bharwada, Y; Zearmal, S; Evans, H; Panikkar, M; de la Cruz, G; Caplan, J; Ruparelia, A; Tanvir, T; Soare, C; L Pang, Y; Trotter, J; Zaidi, A; Thakrar, V; Pulickal, P; Ahmed, H; Parnell, J; Khan, H; Lennock, S; Ford, V; Pyc, W; Brignall, R; O'Neill, D; Hanna, R; Kane, R; Nicola, M; Rajput, K; Xiao, Y; Warner, C; Michael, S; Wright, E; Juniper, S; Thompson, E; Hoskyns, L; Kanitkar, A; Ross, C; Unsworth, A; Rshaidat, H; Demarre, K; Chiang, A; Bareh, A; van Dellen, J; Faqihinejad, C; Gadhvi, A; Grant, R; Lewsey, J; Morris, A; Martin, H; Mcclarty, C; Sanyal, S; Alsaif, A; Palkhi, A; Bhopal, S; Vishnu K, S; Papanikolaou, A; Mitra, A; Nur, A; Ali, F; Burford, C; Huq, T; Sloper, W; Irwin, E; Matthews, L; S Ngu, W; Hosfield, T; Muneeb, F; Page, O; Zeb, E; Coey, J; Al-Azzawi, A; Mcintosh, J; Vucicevic, A; Hughes, M; Brooks, L; Fanibi, B; Dixon, M; Njoku, P; Morris, D; Jobson, J; Chowdhury, H; Alawode, Dot; Wynell-Mayow, W; Udayachandran, V; Alsoof, D; Ekert, J; Joseph, N; Zulkefley, N; Hunt, G; Christodoulou, T; Wright, O; Soman, S; Jamal, M; Beqiri, S; Borgas, P; Christie, S; Pereira, F; Browne, S; Yiu, J; Dworkin, A; Brayley, J; Palmer, A; Charalambos, M; S Jones, C; Toner, S; Cowden, R; Lee, L; Nicol, P; Holman, O; Imtiaz, M; Albert, V; P Leung, S; Erotocritou, M; Wong, J; Stroud, R; Mason, D; Wilkin, R; Thomson, W; Mackee, L; G, N; Bei, Y; Sait, S; Mckenna Favier, S; Ibrahim, A; Kler, A; Reynolds, L; H Mohamed, S; Majeed, Y; Fakim, B; Jones, A; Kowal, M; Liversedge, G; Carrington, Z; Windebank, J; Izzarina, A; Akbani, U; Craven, J; Aldarragi, A; Harding, S; Millward, A; C Shortland, T; Bedford, M; Stroud, R; Obukofe, R; Mackenzie, E; Gopalan, V; Midgen, A; Khadka, P; Cheng, O; Taneja, S; Manobharath, N; Y Kok, J; Lim, Dwe; Buick, T; Boland, M; Piya, S; Devlin, R; J Fairfield, C; J George, R; Rahi, M; Zaman, S; Hajiev, S; Ross, T; Owen, M; Crisp, E; Thompson, C; Charalambous, A; L Hollywood, J; Saiyed, A; Hammond, Rfl; Matthews, J; Mendonca, V; Spinty, J; Khan, K; Cheng, J; Glynn, N; Muhammad, U; Khan, M; Anderson, L; Mccormack, K; Mak, J; Patrawala, S; Milinkovic, N; Schofield, R; Chauhan, M; Hartley, L; Hind, J; Ashworth, I; Nelson, L; Ratnasingham, D; Akbari, K; Whitehead, T; Dimitriadis, S; Marshall, K; J Flint, E; Curran, M; Horner, C; Heybourne, A; Morgan, H; Wickstone, C; Panagiotou, D; O'Connell, E; Dean, K; Iqbal, R; Walsh, L; Yu, N; Rana, N; Massie, E; Ng, J; Jung, M; D Lee, Y; Harris, M; White, S; Delibegovic, S; Boev, B; Tonchev, P; Prochazka, V; Örhalmi, J; Riško, J; Skalický, A; Chrz, K; Ravn, S; Ojakäär, A; Duchalais, E; Dörr-Harim, C; Herrle, F; Koutserimpas, C; Giraudo, G; Armellini, A; Ruzzenente, A; Mazzeo, C; De Padua, C; Realis Luc, A; Maroli, A; Giani, I; E Cufari, M; Vitali, M; Ceccarelli, G; P Gusai, G; Quattromani, R; Virgilio, E; Berti, S; Mulas, S; F Di Mola, F; Papagni, V; Tuminello, F; Magnoli, M; Vittori, L; Longheu, A; A Loche, G; Braccio, B; De Luca, E; Resta, G; Ancans, G; Tamosiunas, A; Petrulionis, M; Andrejevic, P; E Stellingwerf, M; Abdulrahman, N; van de Pas, Kgh; Thomas, G; M Brandsma, A; Davids, J; J Rottier, S; de Roy van Zuidewijn, D; Hawkins, R; I Ong, H; Li, Y; Desmond, B; Winstanley, J; Martins, M; Rosete, M; Americano, M; Santos, M; Frade, S; Senhorinho, R; Peixoto, R; Alagoa João, A; Alves-Vale, C; Lamas, M; B O'Connor, D; Hoo, M; Gopaul, A; Scanlon, K; O'Dwyer, N; Negoi, I; Jovanović, M; Panyko, A; De Lima, H; Van Vuuren, S; Centeno, A; R Bernado, I; Paniagua Garcia Señorans, M; González Amor, L; Cuenca Ramírez, A; Abrisqueta, J; Estaire Gomez, M; Arroyo, A; Cerdán, C; Gómez Romeu, N; Forero-Torres, A; M Enriquez-Navascues, J; Collado-Roura, F; Curchod, P; Gaspar, S; Imadalou, L; Mutlu, D; Akyol, C; A Uygur, F; C Eray, I; Biyiklioglu, O; F Çetin, M; E Isik, A; Karip, B; Dogan, H; Sarıgül, L; Tunc, E; Aydin, T; Bodur, S; Karabulut, K; A Francis, A; Al-Hadithi, A; To, N; Lau, Isf; Smith, E; Mahapatra, S; Mcauliffe, O; A Francis, A; Imam, L; Akram, B; Hossaini, S; Davies, R; Ko, M; Collins, J; Pandya, A; Reilly, S; Archer, J; Auty, C; D Roche, C; Livie, J; A Chaudhry, F; Ntakomyti, E; Diallo, R; Bylinski, T; Wright, J; Lawday, S; Masiha, E; Tung, J; Shirazi, B; Neilson, A; Epton, S; Patel, N; Trussell, S; Couldrey, A; Donnelly, C; Eftychiou, S. - In: BRITISH JOURNAL OF SURGERY. - ISSN 1365-2168. - 107:5(2020), pp. 552-559. [10.1002/bjs.11422]
Safety of hospital discharge before return of bowel function after elective colorectal surgery
E VirgilioMembro del Collaboration Group
;
2020-01-01
Abstract
Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
