泌尿妇科手术后居家移除导尿管的回顾性队列研究

IF 0.8 Q4 OBSTETRICS & GYNECOLOGY Urogynecology (Hagerstown, Md.) Pub Date : 2024-06-01 Epub Date: 2024-01-16 DOI:10.1097/SPV.0000000000001430
Abigail P Davenport, Yi W Li, Lucie T Lefbom, Cheryl B Iglesia, Alexis A Dieter
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引用次数: 0

摘要

重要性:诊室内术后排尿试验(VT)增加了患者和医生的医疗负担。采用居家排尿试验可在不增加术后不良事件的情况下减轻负担:本研究的目的是比较在 "经尿道导尿管自行停用的医疗保健利用率和可行性评估"(FLOTUS)研究中导尿管自行停用后进行居家自动充盈排尿试验的参与者与在术后第 1 天(POD)到诊室进行回填辅助排尿试验的 "历史 "对照组患者的术后 30 天结果:这是一项回顾性队列研究,研究对象是 2020 年 6 月至 2022 年 3 月期间接受泌尿妇科手术后出现术后尿潴留的女性患者。FLOTUS研究的结果与 "历史 "对照组患者进行了比较,"历史 "对照组患者是在FLOTUS启动前一年的病历审查中确定的。研究收集了人口统计学、病史和手术相关数据。三十天的结果数据包括诊室电话/信息、诊室就诊、急诊就诊、并发症和导管插入结果:结果:FLOTUS队列中有46名参与者,历史队列中有65名参与者。两组患者的 POD1 VT 通过率、办公室电话/信息数量、急诊就诊次数和术后并发症均无差异。FLOTUS患者少去了一次诊室(1次与2次诊室,PC结论:与在家拔除导管的患者相比,在 POD1 进行反向充填辅助 VT 的患者多就诊一次。
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A Retrospective Cohort Study of At-Home Catheter Removal After Urogynecologic Surgery.

Importance: In-office postoperative voiding trials (VTs) increase health care burden for patients and physicians. Adoption of an at-home VT option may decrease burden without increasing adverse events postoperatively.

Objective: The purpose of this study was to compare 30-day postoperative outcomes between participants who performed an at-home autofill VT after catheter self-discontinuation during the Assessing Healthcare Utilization and Feasibility of Transurethral Catheter Self-discontinuation (FLOTUS) study and a "historic" control cohort of patients who presented to the office for backfill-assisted VT on postoperative day (POD) 1.

Study design: This was a retrospective cohort study of women with postoperative urinary retention after urogynecologic surgery between June 2020 and March 2022. Outcomes from the FLOTUS study were compared with a "historic" control cohort of patients that were identified on chart review from the year before FLOTUS initiation. Demographic, medical history, and procedure-related data were collected. Thirty-day outcome data included office calls/messages, office visits, emergency department visits, complications, and catheterization outcomes.

Results: Forty-six participants were included in the FLOTUS cohort and 65 participants in the historic cohort. There was no difference in the POD1 VT pass rate, number of office calls/messages, emergency department visits, or postoperative complications between the 2 cohorts. The FLOTUS patients attended 1 less office visit (1 vs 2 office visits, P <0.001), and this difference persisted on regression analysis (-0.87 office visits; 95% CI, -1.18 to -0.56, P <0.001).

Conclusion: Patients who had backfill-assisted VTs on POD1 attended 1 additional office visit compared with those who removed their catheters at home.

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