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Related Experiment Videos

Adult tonsillectomy: what proportion would accept same day discharge?

S J Moralee1

  • 1Department Otolaryngology, Edinburgh Royal Infirmary, Edinburgh, UK.

Journal of the Royal College of Surgeons of Edinburgh
|June 11, 1998
PubMed
Summary

Only 52% of adults undergoing tonsillectomy would accept same day discharge. Pain and nausea were primary reasons for refusal, impacting the economic benefits of day surgery.

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Area of Science:

  • Otolaryngology
  • Surgical Outcomes
  • Health Economics

Background:

  • Day case surgery is increasingly adopted to enhance healthcare cost efficiency.
  • The financial advantages of same-day surgery are contingent upon patient acceptance of immediate discharge.
  • Tonsillectomy is a common surgical procedure where day case management is considered.

Purpose of the Study:

  • To determine the proportion of adult tonsillectomy patients willing to accept same-day discharge.
  • To identify the primary reasons for patient refusal of same-day discharge after tonsillectomy.
  • To explore factors influencing patient decisions regarding same-day discharge.

Main Methods:

  • Prospective study of 50 consecutive adult patients undergoing in-patient tonsillectomy who met day surgery criteria.
  • Standardized anesthetic, surgical technique, analgesia, and antiemetic protocols were applied to all participants.
  • Patients were assessed for discharge eligibility and willingness 8 hours post-surgery, with reasons for refusal and additional morphine use recorded.

Main Results:

  • 52% of patients were willing to accept same-day discharge.
  • Key reasons for refusal included pain (46%), nausea (33%), dizziness (13%), and combined pain and nausea (8%).
  • Patients refusing discharge were three times more likely to require additional morphine.

Conclusions:

  • Patient acceptance of same-day discharge after tonsillectomy is lower than anticipated, potentially limiting economic benefits.
  • Pain and nausea are significant barriers to same-day discharge, necessitating optimized post-operative management.
  • Findings suggest potential sampling bias when compared to international studies, warranting further investigation.

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