Same-day discharge for pediatric Nuss procedure; an analysis of the NSQIP-pediatric database from 2017-2022.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-11-08 DOI:10.1007/s00383-024-05890-y

John M Woodward, Ali M A Khan, Stephanie F Brierley, Krystle Bittner, Hector Osei, Keihan Mostafavi, Carroll M Harmon, P Benson Ham

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引用次数: 0

Abstract

Purpose: Limited data exists evaluating same-day discharge for pediatric Nuss procedure; most being single-center studies. Our analysis, using the NSQIP-P registry, aimed to assess if same-day discharge for the Nuss procedure influenced post-operative outcomes.

Methods: The NSQIP-P database (2017-2022) identified patients who underwent the Nuss procedure. Patients discharged same-day postoperatively (SDD) were compared to those discharged 1-7 days postoperatively (non-SDD).

Results: Of 5486 patients identified, 91 (1.7%) were SDD. From 2018 to 2022, the annual SDD rate increased from 0.8% to 2.7%. There was no significant difference between SDD and non-SDD groups for 30-day readmission (1.1% vs 3.5%, p = 0.376), reoperation (0% vs 1.5%, p = 0.643), or other outcomes. Twenty-six patients required readmission or reoperation within 3-days; only one underwent SDD. The most common readmission was for pain (n = 4) and reoperation for chest-tube placement (n = 10). Asthma (OR 1.66, 95% CI 1.03-2.67, p = 0.038), and increased operative time (per 10 min increment: OR 1.060, 95% CI 1.034-1.086, p < 0.001) each increased risk of readmission or reoperation.

Conclusion: Same-day discharge for the Nuss procedure, although infrequent, has increased without significant differences in complications in the 91 patients who were discharged same-day in this analysis. Same-day discharge for Nuss procedure is reasonable for non-asthmatic patients with a satisfactory postoperative x-ray and meeting other goal-based discharge criteria, including adequate pain control.

Level of evidence (i-v): Level III.

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小儿努斯手术当天出院；2017-2022年NSQIP儿科数据库分析。

目的：评估小儿努斯手术当日出院的数据有限，大多数都是单中心研究。我们利用 NSQIP-P 注册表进行分析，旨在评估努斯手术当天出院是否会影响术后效果：NSQIP-P数据库（2017-2022年）确定了接受努斯手术的患者。将术后当天出院（SDD）的患者与术后1-7天出院（非SDD）的患者进行比较：在5486名已确认的患者中，91人（1.7%）为SDD。从2018年到2022年，每年的SDD率从0.8%上升到2.7%。SDD 组和非 SDD 组在 30 天再入院（1.1% vs 3.5%，p = 0.376）、再次手术（0% vs 1.5%，p = 0.643）或其他结果方面没有明显差异。26 名患者需要在 3 天内再次入院或再次手术，其中只有一人接受了 SDD。最常见的再入院原因是疼痛（4 例）和因放置胸管而再次手术（10 例）。哮喘（OR 1.66，95% CI 1.03-2.67，p = 0.038）和手术时间延长（每增加 10 分钟：OR为1.060，95% CI为1.034-1.086，P为0.038：尽管努斯手术当天出院的情况并不常见，但在本次分析中，当天出院的 91 名患者中并发症发生率并无显著差异。对于术后X光检查结果令人满意且符合其他基于目标的出院标准（包括充分的疼痛控制）的非哮喘患者来说，努斯手术当天出院是合理的：III级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor