Limited English proficiency is associated with longer surgical admission length of stay

Narrative synthesis #

The review lists surgical admission LOS among the perioperative process-of-care outcomes most consistently associated with LEP, but the underlying evidence is genuinely mixed: 5 studies found significantly prolonged total LOS in patients with LEP (CABG, craniotomy, intestinal/rectal, hip arthroplasty), 8 studies found no association, and 1 study found shorter total LOS for Spanish-speaking LEP after appendectomy/adhesiolysis (though longer LOS in a high-risk subcohort). The abstract frames this as "longer surgical admission length of stay in 6 of 14 studies." High heterogeneity in how LOS was defined and dichotomized limits synthesis. Certainty/GRADE appraisal is left for expert review.

"Five studies found significantly prolonged total LOS in patients with LEP admitted for surgical procedures, including for coronary artery bypass graft, craniotomy, intestinal and rectal surgery, hip arthroplasty, and knee arthroplasty. Of these 5 studies, 1 study demonstrated mixed results depending on surgical cohorts... Eight studies found no association between LEP and total or postoperative LOS. A single study found that patients with Spanish-speaking LEP had shorter total LOS for appendectomy..." (Joo, 2023, p. 7)

"Surgical patients with limited English proficiency were more likely to experience... longer surgical admission length of stay in 6 of 14 studies..." (Joo, 2023, p. 1)

Reviewer note (probable-merge / tension): overlaps with the existing corpus CLM "Language discordance (LEP status) is not consistently associated with longer hospital length of stay" — that CLM frames the exposure signal as weak/null across the broader corpus; this one captures this review's framing of LOS as a comparatively consistent process-of-care disparity. Human should decide whether to merge or wire as opposing/qualifying.