微创子宫切除术当天出院:预测因素的系统回顾和荟萃分析。

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Archives of Gynecology and Obstetrics Pub Date : 2024-10-28 DOI:10.1007/s00404-024-07794-7
Xue Dong, Ai Zheng, Xin Tan, Tao Guo
{"title":"微创子宫切除术当天出院:预测因素的系统回顾和荟萃分析。","authors":"Xue Dong, Ai Zheng, Xin Tan, Tao Guo","doi":"10.1007/s00404-024-07794-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Same-day discharge (SDD) is increasingly prevalent following minimally invasive hysterectomy (MIH). However, consensus guidelines for selecting SDD eligibility criteria for MIH remain unexplored. This study aims to identify predictive factors for non-SDD following MIH (registered in PROSPERO CRD42022350373).</p><p><strong>Methods: </strong>PubMed, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials. All original studies that involve patients who were discharged on the same day are compared with those who were not (not failure to discharge / not intended to discharge). Categorical and continuous variables were reported as risk ratios with 95% confidence intervals and weighted mean differences with 95% CIs, respectively. Heterogeneity among the included studies was assessed using the I2 statistics. We conducted sensitivity analysis to identify the reason(s) for this heterogeneity.</p><p><strong>Results: </strong>Ten studies (59,589 patients) were included, with a mean SDD rate of 20.28%. The predictors of overnight observation included factors such as American Society of Anesthesiologists classification (ASA) > II (P = .02; I<sup>2</sup> = 92%), increased estimated blood loss (EBL) (P < 0.00001; I<sup>2</sup> = 87%), surgeries starting later in the day (P < 0.00, I<sup>2</sup> = 15%), and longer operation times (P = .002; I<sup>2</sup> = 96%). In sensitivity and subgroup analyses, uterus weight emerged as a potential factor (P < 0.00; I<sup>2</sup> = 50%), while the results concerning ASA, uterine weight, and EBL appeared to be homogeneous. However, the operation time remained heterogeneous.</p><p><strong>Conclusion: </strong>These factors could assist surgeons in the decision-making process regarding the performance of SDD subsequent to MIH procedures for patients.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Minimally invasive hysterectomy same-day discharge: systematic review and meta-analysis of predictors.\",\"authors\":\"Xue Dong, Ai Zheng, Xin Tan, Tao Guo\",\"doi\":\"10.1007/s00404-024-07794-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Same-day discharge (SDD) is increasingly prevalent following minimally invasive hysterectomy (MIH). However, consensus guidelines for selecting SDD eligibility criteria for MIH remain unexplored. This study aims to identify predictive factors for non-SDD following MIH (registered in PROSPERO CRD42022350373).</p><p><strong>Methods: </strong>PubMed, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials. All original studies that involve patients who were discharged on the same day are compared with those who were not (not failure to discharge / not intended to discharge). Categorical and continuous variables were reported as risk ratios with 95% confidence intervals and weighted mean differences with 95% CIs, respectively. Heterogeneity among the included studies was assessed using the I2 statistics. We conducted sensitivity analysis to identify the reason(s) for this heterogeneity.</p><p><strong>Results: </strong>Ten studies (59,589 patients) were included, with a mean SDD rate of 20.28%. The predictors of overnight observation included factors such as American Society of Anesthesiologists classification (ASA) > II (P = .02; I<sup>2</sup> = 92%), increased estimated blood loss (EBL) (P < 0.00001; I<sup>2</sup> = 87%), surgeries starting later in the day (P < 0.00, I<sup>2</sup> = 15%), and longer operation times (P = .002; I<sup>2</sup> = 96%). In sensitivity and subgroup analyses, uterus weight emerged as a potential factor (P < 0.00; I<sup>2</sup> = 50%), while the results concerning ASA, uterine weight, and EBL appeared to be homogeneous. However, the operation time remained heterogeneous.</p><p><strong>Conclusion: </strong>These factors could assist surgeons in the decision-making process regarding the performance of SDD subsequent to MIH procedures for patients.</p>\",\"PeriodicalId\":8330,\"journal\":{\"name\":\"Archives of Gynecology and Obstetrics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-10-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Gynecology and Obstetrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00404-024-07794-7\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Gynecology and Obstetrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00404-024-07794-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的:微创子宫切除术(MIH)后当天出院(SDD)的情况越来越普遍。然而,选择微创子宫切除术 SDD 资格标准的共识指南仍未得到探讨。本研究旨在确定微创子宫切除术(已在 PROSPERO CRD42022350373 登记)后非 SDD 的预测因素:方法:PubMed、EMBASE、ClinicalTrials.gov 和 Cochrane Central Register of Controlled Trials。所有涉及当天出院患者与未出院患者(非未能出院/未打算出院)的原始研究均进行比较。分类变量和连续变量分别以风险比(含 95% 置信区间)和加权平均差(含 95% 置信区间)的形式报告。使用 I2 统计量评估了纳入研究之间的异质性。我们进行了敏感性分析,以找出异质性的原因:共纳入 10 项研究(59,589 名患者),平均 SDD 率为 20.28%。过夜观察的预测因素包括美国麻醉医师协会分类(ASA)> II(P = .02;I2 = 92%)、估计失血量(EBL)增加(P 2 = 87%)、手术开始时间较晚(P 2 = 15%)和手术时间较长(P = .002;I2 = 96%)。在敏感性和亚组分析中,子宫重量是一个潜在因素(P 2 = 50%),而ASA、子宫重量和EBL的结果似乎是一致的。结论:这些因素可以帮助外科医生进行手术:这些因素可帮助外科医生在为患者实施MIH手术后进行SDD的决策过程中提供帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Minimally invasive hysterectomy same-day discharge: systematic review and meta-analysis of predictors.

Purpose: Same-day discharge (SDD) is increasingly prevalent following minimally invasive hysterectomy (MIH). However, consensus guidelines for selecting SDD eligibility criteria for MIH remain unexplored. This study aims to identify predictive factors for non-SDD following MIH (registered in PROSPERO CRD42022350373).

Methods: PubMed, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials. All original studies that involve patients who were discharged on the same day are compared with those who were not (not failure to discharge / not intended to discharge). Categorical and continuous variables were reported as risk ratios with 95% confidence intervals and weighted mean differences with 95% CIs, respectively. Heterogeneity among the included studies was assessed using the I2 statistics. We conducted sensitivity analysis to identify the reason(s) for this heterogeneity.

Results: Ten studies (59,589 patients) were included, with a mean SDD rate of 20.28%. The predictors of overnight observation included factors such as American Society of Anesthesiologists classification (ASA) > II (P = .02; I2 = 92%), increased estimated blood loss (EBL) (P < 0.00001; I2 = 87%), surgeries starting later in the day (P < 0.00, I2 = 15%), and longer operation times (P = .002; I2 = 96%). In sensitivity and subgroup analyses, uterus weight emerged as a potential factor (P < 0.00; I2 = 50%), while the results concerning ASA, uterine weight, and EBL appeared to be homogeneous. However, the operation time remained heterogeneous.

Conclusion: These factors could assist surgeons in the decision-making process regarding the performance of SDD subsequent to MIH procedures for patients.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
期刊最新文献
Real-world data of perioperative complications in prepectoral implant-based breast reconstruction: a prospective cohort study. High-altitude hypoxia exposure alters follicular metabolome and oocyte developmental potential in women. Evaluation of the clinical utility of NIPT-plus and analysis of adverse pregnancy outcomes. Comparison of the complications rate of different suture-passing techniques at the time of sacrospinous ligament fixation: a systematic review and meta-analysis. Paracetamol versus ibuprofen for early postpartum pain control: a randomized controlled trial.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1