Kamil Malshy, Alejandra Balen, Borivoj Golijanin, Maximilian Jentzsch, Rachel Greenberg, Frances Kazal, Richard Glebocki, Katherine Danaher, Ryland Spence, Elias Hyams, Dragan Golijanin, Gyan Pareek, Samuel Eaton
{"title":"优化术后护理:经尿道前列腺切除术后当天出院。","authors":"Kamil Malshy, Alejandra Balen, Borivoj Golijanin, Maximilian Jentzsch, Rachel Greenberg, Frances Kazal, Richard Glebocki, Katherine Danaher, Ryland Spence, Elias Hyams, Dragan Golijanin, Gyan Pareek, Samuel Eaton","doi":"10.1177/17504589241251697","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to assess the feasibility and safety of same-day discharge after transurethral resection of the prostate.</p><p><strong>Materials and methods: </strong>Five years of records were retrospectively analysed. Length of stay categorised patients into Groups 1 (same-day discharge) and 2 (standard-length discharge). Logistic regression analysis was performed, controlling for clinicodemographic factors. Student's t-test compared continuous bladder irrigation and catheter dwell times.</p><p><strong>Results: </strong>A total of 459 patients were identified between 2016 and 2021, 280 in Group 1 and 179 in Group 2, with median ages of 71.0 (interquartile range 36-92) and 72.0 (interquartile range 47-101) years (p = 0.067), respectively. Same-day discharge rates notably increased post-2018 (p = 0.025). Median prostate tissue resected in Group 2 was 7.1g (3.4-12.4g) and in Group 1 was 4.9g (2.4-10.2g; p = 0.034). While continuous bladder irrigation >1 hour was significantly lower in Group 1 than Group 2 (96.8% versus 27.4%; p = 0.0001), catheter dwell times were comparable (70.1 and 70.8 hours, respectively). Control-adjusted results showed a 40% reduction in emergency department representation odds for Group 1 compared with Group 2 (odds ratio = 0.60; 95% confidence interval = 0.37-0.99; p = 0.04). Length of stay was not significantly associated with hospital readmissions (p = 0.11). Continuous bladder irrigation for <1 hour in Group 1 was associated with a reduced emergency department representation (odds ratio = 0.43; 95% confidence interval = 0.197-0.980) but not readmission (odds ratio = 0.413; 95% confidence interval = 0.166-1.104).</p><p><strong>Conclusions: </strong>Same-day discharge post-transurethral resection of the prostate may be a viable and safe option for carefully selected patients.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Optimising postoperative care: Same-day discharge after transurethral resection of the prostate.\",\"authors\":\"Kamil Malshy, Alejandra Balen, Borivoj Golijanin, Maximilian Jentzsch, Rachel Greenberg, Frances Kazal, Richard Glebocki, Katherine Danaher, Ryland Spence, Elias Hyams, Dragan Golijanin, Gyan Pareek, Samuel Eaton\",\"doi\":\"10.1177/17504589241251697\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study aims to assess the feasibility and safety of same-day discharge after transurethral resection of the prostate.</p><p><strong>Materials and methods: </strong>Five years of records were retrospectively analysed. Length of stay categorised patients into Groups 1 (same-day discharge) and 2 (standard-length discharge). Logistic regression analysis was performed, controlling for clinicodemographic factors. Student's t-test compared continuous bladder irrigation and catheter dwell times.</p><p><strong>Results: </strong>A total of 459 patients were identified between 2016 and 2021, 280 in Group 1 and 179 in Group 2, with median ages of 71.0 (interquartile range 36-92) and 72.0 (interquartile range 47-101) years (p = 0.067), respectively. Same-day discharge rates notably increased post-2018 (p = 0.025). Median prostate tissue resected in Group 2 was 7.1g (3.4-12.4g) and in Group 1 was 4.9g (2.4-10.2g; p = 0.034). While continuous bladder irrigation >1 hour was significantly lower in Group 1 than Group 2 (96.8% versus 27.4%; p = 0.0001), catheter dwell times were comparable (70.1 and 70.8 hours, respectively). Control-adjusted results showed a 40% reduction in emergency department representation odds for Group 1 compared with Group 2 (odds ratio = 0.60; 95% confidence interval = 0.37-0.99; p = 0.04). Length of stay was not significantly associated with hospital readmissions (p = 0.11). Continuous bladder irrigation for <1 hour in Group 1 was associated with a reduced emergency department representation (odds ratio = 0.43; 95% confidence interval = 0.197-0.980) but not readmission (odds ratio = 0.413; 95% confidence interval = 0.166-1.104).</p><p><strong>Conclusions: </strong>Same-day discharge post-transurethral resection of the prostate may be a viable and safe option for carefully selected patients.</p>\",\"PeriodicalId\":35481,\"journal\":{\"name\":\"Journal of perioperative practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-05-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of perioperative practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/17504589241251697\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of perioperative practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/17504589241251697","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Optimising postoperative care: Same-day discharge after transurethral resection of the prostate.
Introduction: This study aims to assess the feasibility and safety of same-day discharge after transurethral resection of the prostate.
Materials and methods: Five years of records were retrospectively analysed. Length of stay categorised patients into Groups 1 (same-day discharge) and 2 (standard-length discharge). Logistic regression analysis was performed, controlling for clinicodemographic factors. Student's t-test compared continuous bladder irrigation and catheter dwell times.
Results: A total of 459 patients were identified between 2016 and 2021, 280 in Group 1 and 179 in Group 2, with median ages of 71.0 (interquartile range 36-92) and 72.0 (interquartile range 47-101) years (p = 0.067), respectively. Same-day discharge rates notably increased post-2018 (p = 0.025). Median prostate tissue resected in Group 2 was 7.1g (3.4-12.4g) and in Group 1 was 4.9g (2.4-10.2g; p = 0.034). While continuous bladder irrigation >1 hour was significantly lower in Group 1 than Group 2 (96.8% versus 27.4%; p = 0.0001), catheter dwell times were comparable (70.1 and 70.8 hours, respectively). Control-adjusted results showed a 40% reduction in emergency department representation odds for Group 1 compared with Group 2 (odds ratio = 0.60; 95% confidence interval = 0.37-0.99; p = 0.04). Length of stay was not significantly associated with hospital readmissions (p = 0.11). Continuous bladder irrigation for <1 hour in Group 1 was associated with a reduced emergency department representation (odds ratio = 0.43; 95% confidence interval = 0.197-0.980) but not readmission (odds ratio = 0.413; 95% confidence interval = 0.166-1.104).
Conclusions: Same-day discharge post-transurethral resection of the prostate may be a viable and safe option for carefully selected patients.
期刊介绍:
The Journal of Perioperative Practice (JPP) is the official journal of the Association for Perioperative Practice (AfPP). It is an international, peer reviewed journal with a multidisciplinary ethos across all aspects of perioperative care. The overall aim of the journal is to improve patient safety through informing and developing practice. It is an informative professional journal which provides current evidence-based practice, clinical, management and educational developments for practitioners working in the perioperative environment. The journal promotes perioperative practice by publishing clinical research-based articles, literature reviews, topical discussions, advice on clinical issues, current news items and product information.