腮腺切除术趋向于在门诊治疗良性疾病。

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Andrew D P Prince, Kimberly Oslin, Josh D Smith, Emma Hershey, Lisa Chionis, Michael Allevato, Steven B Chinn, Mark E P Prince
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引用次数: 0

摘要

目的:评估门诊腮腺切除术的安全性:我们评估了门诊腮腺切除术的安全性。我们对导致计划入院的因素进行评估,并对成本进行比较。我们评估了门诊的趋势,以及转换入院状态、全切法与浅切法、门诊与住院地点的结果:研究设计:回顾性队列研究:研究设计:回顾性队列研究:回顾性分析2018年至2023年因良性肿瘤接受腮腺切除术的患者.结果:在370例腮腺切除术中,计划入院162例,门诊208例。旅行时间>60分钟(几率比[OR] = 0.487,置信区间[CI]:0.296-0.803,P = .005)和全腮切除术(OR = 0.448,CI:0.226-0.89,P = .022)降低了计划门诊手术的几率。在多变量模型中,手术时间延长会增加转为住院的几率(n = 29,OR = 1.02,CI:1.007-1.033,P = .002),而放置引流管会降低转为门诊的几率(n = 15,OR = 0.035,CI:0.004-0.298,P = .002)。门诊患者和住院患者在手术并发症、电话、门诊就诊、再入院率或复发率方面没有明显差异。在比较手术设施、浅表腮腺切除术与全腮腺切除术时,情况依然如此。在 COVID 被宣布为急诊后,门诊患者倾向于接受腮腺切除术(72.7% 对 48.9%,P 结论:门诊患者的腮腺切除率高于住院患者:本研究证实门诊腮腺切除术是安全的。对于转换入院状态、接受浅表或全腮腺切除术以及在非住院地点进行手术的患者来说,情况依然如此。我们证明,医疗机构可以安全地提高门诊腮腺切除术的比例,而且门诊腮腺切除术具有成本效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Parotidectomy Trends Toward Outpatient for Benign Disease.

Objective: We evaluate the safety of outpatient parotidectomy. We evaluate factors that lead to planned admission and compare costs. We evaluate trends toward outpatient, and the outcomes of switching admission status, total versus superficial approach, and ambulatory versus hospital site.

Study design: Retrospective cohort study.

Setting: Single tertiary academic center.

Methods: Retrospective review of patients who underwent parotidectomy for benign tumors from 2018 to 2023.

Results: Of 370 parotidectomies performed, there were a planned 162 admissions and 208 outpatient procedures. A travel time > 60 minutes (odds ratio [OR] = 0.487, confidence interval [CI]: 0.296-0.803, P = .005) and total parotidectomy (OR = 0.448, CI: 0.226-0.89, P = .022) decreased the odds of a planned outpatient procedure. In a multivariable model, longer operative time increased the odds of switching to inpatient (n = 29, OR = 1.02, CI: 1.007-1.033, P = .002) and drain placement decreased the odds of switching to outpatient (n = 15, OR = 0.035, CI: 0.004-0.298, P = .002). There was no significant difference in surgical complications, phone calls, clinic visits, readmission rates, or recurrence between outpatient and inpatient. This remained true when comparing surgical facility and superficial versus total parotidectomy. After COVID was declared an emergency, there was a trend toward outpatient parotidectomy (72.7% vs 48.9%, P < .001), but no change in complication rates. At our institution, outpatient parotidectomy saved $3838 compared to overnight admission.

Conclusion: This study supports that outpatient parotidectomy is safe. This remained true for patients switching admission status, undergoing superficial or total parotidectomy, and having their operation at an ambulatory site. We demonstrate that institutions can safely increase outpatient parotidectomy rates and outpatient parotidectomy is cost effective.

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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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