在结直肠手术中同日出院:谁需要无计划的夜间监测?
Torbjorg Holtestaul1, Michael Vu1, Grace Pak1
1Madigan Army Medical Center, Tacoma, WA, USA.
American journal of surgery
|April 8, 2024
概括
切除术后的同日出院 (SDD) 是可行的,但需要仔细选择患者. 运营复杂性和社会因素是意外入院的主要原因,突出了协议改进的关键领域.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 外科手术的结果
- 患者出院协议 患者出院协议
背景情况:
- 手术后增强恢复 (ERAS) 协议和微创手术已经减少了结肠直肠手术住院时间.
- 我们的机构为结直肠外科手术患者推出了同一天出院 (SDD) 协议.
- 这项研究旨在确定与SDD候选人计划外入学相关的因素.
研究的目的:
- 评估同日出院 (SDD) 大肠直肠协议的可行性.
- 确定导致结直肠手术后意外入院的因素.
- 为改进SDD协议提供信息,以改善患者选择和结果.
主要方法:
- 对2019年2月至2022年1月期间接受结直肠手术的患者进行了回顾性审查.
- 分析了被确定为潜在的SDD候选人的患者.
- 人口统计学,临床特征和结果在成功出院和入院队列之间进行了比较.
主要成果:
- 在152名潜在的SDD患者中,47名患者在同一天成功出院.
- 非计划入院的主要原因 (n=105) 是操作复杂性 (47.6%) 和社会因素 (23.8%).
- 被录取的队列年龄较大,更有可能经历低前切除或右切除术;病例复杂性是影响入院的最重要因素.
结论:
- 同一天出院 (SDD) 是可以实现的选择结肠直肠手术患者.
- 运营复杂性和社会决定因素是需要偏离SDD协议的关键因素.
- 进一步的协议优化应专注于解决这些已识别的入学驱动因素.
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