دورية أكاديمية
أعرض في EDS

Assessment of the feasibility of same-day discharge following minimally invasive hysterectomy in the elderly population.

التفاصيل البيبلوغرافية
العنوان: Assessment of the feasibility of same-day discharge following minimally invasive hysterectomy in the elderly population.
المؤلفون: Haight PJ; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA., Piver RN; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA., Barrington DA; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA., Baek J; The Ohio State University College of Medicine, Columbus, OH, USA., Graves SM; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA., Ardizzone M; The Ohio State University College of Medicine, Columbus, OH, USA., Akinduro JA; The Ohio State University College of Medicine, Columbus, OH, USA., Busho AC; The Ohio State University College of Medicine, Columbus, OH, USA., Fadoju D; The Ohio State University College of Medicine, Columbus, OH, USA., Pandit R; The Ohio State University College of Medicine, Columbus, OH, USA., Stephens R; The Ohio State University College of Medicine, Columbus, OH, USA., Strowder LM; The Ohio State University College of Medicine, Columbus, OH, USA., Tadepalli S; The Ohio State University College of Medicine, Columbus, OH, USA., VanNoy B; The Ohio State University College of Medicine, Columbus, OH, USA., Sriram B; The Ohio State University College of Medicine, Columbus, OH, USA., McLaughlin EM; Center for Biostatistics, The Ohio State University College of Medicine, Columbus, OH, USA., Ds Lightfoot M; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA., Chambers LM; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA., Bixel KL; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA., Cohn DE; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA., Cosgrove CM; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA., O'Malley D; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA., Salani R; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA., Backes FJ; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA., I Nagel C; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, Columbus, OH, USA.
المصدر: Gynecologic oncology reports [Gynecol Oncol Rep] 2023 Jun 19; Vol. 48, pp. 101227. Date of Electronic Publication: 2023 Jun 19 (Print Publication: 2023).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101652231 Publication Model: eCollection Cited Medium: Print ISSN: 2352-5789 (Print) Linking ISSN: 23525789 NLM ISO Abbreviation: Gynecol Oncol Rep Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Amsterdam : Elsevier, [2013]-
مستخلص: Objective: To determine the safety and feasibility of same-day discharge (SDD) following minimally invasive hysterectomy (MIH) for elderly patients and to evaluate associations between age, frailty, and postoperative outcomes.
Methods: Retrospective review was conducted of patients aged ≥ 70 who underwent MIH within a single gynecologic oncology institution from 2018 to 2020. Demographics, peri -operative factors, postoperative complications, and 30-day readmission rates were collected. Frailty was determined by an 11-point modified frailty index ≥ 2. Outcomes were compared between SDD and observation groups using Fisher's exact and Wilcoxon rank-sum tests.
Results: Of 169 patients included in the analysis, 8.9% (n = 15) underwent SDD, and 91.1% (n = 154) were admitted for OBS following MIH. Demographics, peri -operative factors, and frailty rates (33% SDD vs 43.5% observation; p = 0.59) were similar between groups. 86.7% (n = 13) of SDD cases were completed before 12PM, and none were completed after 6PM. No SDD patients had early post-operative complications or hospital readmissions. Early postoperative complications were diagnosed in 9 (5.8%) patients admitted for OBS, and the 30-day hospital readmission rate for patients who underwent OBS was 8.4% (n = 13). While elderly patients who met objective frailty criteria (n = 72) did not have a higher likelihood of early post-operative complications (44.4% vs 55.6%; p = 0.909), they did have a higher likelihood of ED visit within 30 days of discharge (15.3 vs 3.1%; p = 0.009), and a trend was noted toward a higher rate of 30-day hospital readmission (12.5% vs 4.1%; p = 0.080).
Conclusions: Elderly patients undergoing SDD following MIH did not have increased morbidity or mortality. Elderly patients who meet objective criteria for frailty, however, represent a more vulnerable population.
Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2023 The Author(s).)
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فهرسة مساهمة: Keywords: Elderly; Frailty; Minimally invasive hysterectomy; Same-day discharge
تواريخ الأحداث: Date Created: 20230707 Latest Revision: 20230718
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10320489
DOI: 10.1016/j.gore.2023.101227
PMID: 37415961
قاعدة البيانات: MEDLINE
الوصف
تدمد:2352-5789
DOI:10.1016/j.gore.2023.101227