儿科Nuss手术的同日出院;对2017-2022年NSQIP-儿科数据库的分析
John M Woodward1,2, Ali M A Khan3, Stephanie F Brierley1
1Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, 14215, USA.
Pediatric surgery international
|November 8, 2024
概括
儿科Nuss手术后的同日出院 (SDD) 是增加和安全的,并没有明显的并发症差异. 对于符合出院标准的非喘患者,包括疼痛控制,SDD是合理的.
科学领域:
- 儿科手术 儿科手术
- 胸部外科手术 胸部外科手术
- 外科手术的结果
背景情况:
- 努斯手术是一种常见的手术修复,用于儿童的 pectus excavatum.
- 在Nuss手术后,关于当天放药 (SDD) 的数据有限,大多数研究都是单中心的.
- 评估SDD的安全性和结果对于优化患者护理和医院资源利用至关重要.
研究的目的:
- 评估当日出院 (SDD) 对接受Nuss手术的儿科患者手术后结果的影响.
- 为了比较同一天出院的患者与术后1-7天出院的患者之间的结果.
主要方法:
- 2017-2022年国家外科质量改善计划-儿科 (NSQIP-P) 注册表的分析.
- 确定接受了Nuss手术的患者.
- 在同一天放弃 (SDD) 和非同一天放弃 (非SDD) 组之间的结果比较.
主要成果:
- 在5486名患者中,有91名 (1.7%) 在当天出院. 在2018年至2022年期间,年度SDD利率从0.8%增加到2.7%.
- 在SDD和非SDD组之间30天再入院 (1.1%与3.5%) 或重新手术率 (0%与1.5%) 之间没有发现显著差异.
- 喘和加长的手术时间被确定为重新入院或重新手术的风险因素.
结论:
- 虽然Nuss手术的同日出院不常见,但并没有显著增加并发症.
- 对于一些非喘患者来说,SDD是一种合理的选择,具有令人满意的术后成像和足够的疼痛控制.
- 进一步的研究可以探索患者选择标准,以扩大SDD在Nuss手术中的使用.
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