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المؤلفون: Jasmine Bhinder, David H. Rothstein, Lucy D. Mastrandrea, Moshim Kukar, Kathleen E. Bethin
المصدر: Pediatric Surgery International. 37:1259-1264
مصطلحات موضوعية: medicine.medical_specialty, business.industry, medicine.medical_treatment, Thyroid, Thyroidectomy, Retrospective cohort study, Thyroid Lobectomy, General Medicine, Odds ratio, Logistic regression, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030225 pediatrics, Pediatrics, Perinatology and Child Health, Pediatric surgery, medicine, 030211 gastroenterology & hepatology, business, Same day discharge
الوصف: Studies have demonstrated that same-day discharge (SDD) following thyroid resection is safe and feasible in adults but there are no similar studies in the pediatric age group. The purpose of this study is to evaluate the influence of SDD on 30-day readmission rates following thyroid surgery in pediatric patients. This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program–Pediatric database to evaluate 30-day readmission rates among patients
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المؤلفون: Gary W. Nace, Brianne Reisen, Pablo Laje, Meghana V. Kashyap, Matthew A. Hornick
المصدر: Pediatric Surgery International. 37:859-863
مصطلحات موضوعية: Perforated Appendicitis, medicine.medical_specialty, business.industry, General Medicine, Bowel perforation, Emergency department, medicine.disease, Appendicitis, Surgery, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Pediatrics, Perinatology and Child Health, Pediatric surgery, medicine, Operative time, 030211 gastroenterology & hepatology, Observation group, business, Same day discharge
الوصف: To compare the outcomes and hospital charges of patients who underwent laparoscopic appendectomy for non-perforated appendicitis and were discharged home either shortly after the operation after being admitted for overnight observation. Postoperative (30-day) emergency department (ED) visits, hospital readmissions, and reoperations were compared between patients who were discharged shortly after surgery (same-day discharge [SDD] group) and patients who were discharged after spending one night in the hospital (overnight observation group). Study period: July/2015 to June/2019. Patients with perforated appendicitis and/or who spent > 1 night in the hospital were excluded from the study. We did 1957 laparoscopic appendectomies within the 4-year study period. After excluding all non-eligible cases, 930 patients were included in the overnight observation group, and 511 in the SDD group. Mean age and mean operative time were similar in both groups: 11.5 (SD 3.6)/11.8 (SD 3.5) years, and 35 (SD 13)/33 (SD 12) minutes, respectively. There were 24 (2.6%) ED visits within the overnight observation group. Sixteen patients (1.7%) were discharged from the ED, and 8 (0.9%) required a re-admission. There were 11 (2.1%; P = 0.61) ED visits within the SDD group. Six patients (1.1%; P = 0.41) were discharged from the ED, and 5 (1%; P = 0.82) required a readmission. Six of the 11 ED visits within the SDD group occurred on the 5th postoperative day or later, whereas five (1%) occurred within the first 3 days post appendectomy. These five patients would have likely benefited from an overnight admission and were erroneously discharged on the same day of the appendectomy. There were no reoperations in the overnight observation group, but there were 3 reoperations in the SDD group (0.6%, P = 0.01). The reasons for the reoperations (two bowel obstructions and one bowel perforation) were in no way related to the time of the original discharge. The mean hospital charges per patient in the SDD group and the overnight observation group were significantly different: $32,450 and $35,420, respectively (> 9% margin, P
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