Analysis of reasons for unplanned overnight recovery after same-day surgery_West China Medical Journal

Authors：

XIONG Huan ^1,2 , ZHAO Xiaoyan ^1,2 , JIANG Ruilian ¹ , SONG Yinghan ² , SUN Yiyuan ^1,2 ,  LAI Xiaoqin ^1,2

1. Day Surgery Center, West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan 610299, P. R. China;
2. Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LAI Xiaoqin, Email: laixiaoqin@wchscu.cn

Keywords：

Day surgery; same-day surgery; unplanned overnight recovery; surgical scheduling; individual enhanced recovery after surgery

DOI：

10.7507/1002-0179.202310127

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the causes of unplanned overnight recovery of patients after same-day surgery and put forward countermeasures. Methods The data of same-day surgery patients in the Day Surgery Center of West China Tianfu Hospital of Sichuan University between February 2022 and May 2023 were selected. Patients who recovered overnight were defined as the unplanned overnight recovery group, and patients discharged on the same day after surgery were defined as the normal same-day group. The factors of unplanned overnight recovery after same-day surgery were analyzed. Results A total of 4 259 patients were enrolled, of whom 107 patients had unplanned overnight recovery, 4 152 patients were discharged on the same day after surgery, unplanned overnight recovery group accounted for 2.51% (107/4 259). Except for gender and age (P>0.05), there were significant differences between the two groups in the following six aspects: late starting time of surgery, longer distance from home, medical insurance settlement restrictions, pain, postoperative complications, and patient’s own factors (P<0.05). The results of logistic regression analysis showed that the late starting time of surgery [odds ratio (OR)=9.386, 95% confidence interval (CI) (2.993, 29.432), P<0.001], long distance from address [OR=4.828, 95%CI (2.015, 11.568), P<0.001], medical insurance settlement restrictions [OR=10.667, 95%CI (3.712, 30.658), P<0.001], pain [OR=30.514, 95%CI (7.688, 121.115), P<0.001], postoperative complications [OR=9.642, 95%CI (2.425, 38.342), P=0.001], and patient’s own factors [OR=16.087, 95%CI (10.358, 24.985), P<0.001] were risk factors for unplanned overnight recovery in same-day surgery patients. Conclusions The unplanned overnight recovery of same-day surgery patients in West China Tianfu Hospital of Sichuan University is related to six factors: late starting time of surgery, long distance from home, medical insurance settlement restrictions, pain, postoperative complications, and patient’s own factors. Medical staff can take corresponding measures to reduce the unplanned overnight recovery rate of same-day surgery by strict access standards, optimizing surgical scheduling, formulating individualized enhanced recovery after surgery programs, improving support for patient after discharge, and strengthening perioperative health education.

Citation： XIONG Huan, ZHAO Xiaoyan, JIANG Ruilian, SONG Yinghan, SUN Yiyuan, LAI Xiaoqin. Analysis of reasons for unplanned overnight recovery after same-day surgery. West China Medical Journal, 2024, 39(2): 178-183. doi: 10.7507/1002-0179.202310127 Copy

1.	安燚, 王振军. 日间手术的概念和基本问题. 中国实用外科杂志, 2007(1): 38-40.
2.	于丽华. 中国日间手术发展的历程与展望. 中国医院管理, 2016, 36(6): 16-18.
3.	雷甜甜, 梁鹏, 马洪升, 等. 四川大学华西医院日归手术管理实践. 广东医学, 2022, 43(10): 1222-1228.
4.	Duignan M, Lao C, Lawrenson R, et al. A policy of day-case sinonasal surgery is safe, well tolerated and cost-effective. J Laryngol Otol, 2021, 135(4): 341-343.
5.	Mayo BC, Massel DH, Bohl DD, et al. Effect of surgery start time on day of discharge in anterior cervical discectomy and fusion patients. Spine (Phila Pa 1976), 2016, 41(24): 1939-1944.
6.	Ganesan S, Prior AJ, Rubin JS. Unexpected overnight admissions following day-case surgery: an analysis of a dedicated ENT day care unit. Ann R Coll Surg Engl, 2000, 82(5): 327-330.
7.	Rutledge J, Siegel E, Belcher R, et al. Barriers to same-day discharge of patients undergoing total and completion thyroidectomy. Otolaryngol Head Neck Surg, 2014, 150(5): 770-774.
8.	Sultan J, Marflow KZ, Roy B. Unplanned overnight admissions in day-case arthroscopic shoulder surgery. Surgeon, 2012, 10(1): 16-19.
9.	Solodkyy A, Hakeem AR, Oswald N, et al. ‘True day case’ laparoscopic cholecystectomy in a high-volume specialist unit and review of factors contributing to unexpected overnight stay. Minim Invasive Surg, 2018, 2018: 1260358.
10.	Elder M, Steven D, Beasley S, et al. Unplanned overnight hospital admission after strabismus surgery. N Z Med J, 2007, 120(1260): U2681.
11.	Cifarelli CP, McMichael JP, Forman AG, et al. Surgical start time impact on hospital length of stay for elective inpatient procedures. Cureus, 2021, 13(7): e16259.
12.	詹丽莉, 刘洋, 蒋丽莎, 等. 日归模式在日间手术的临床应用与探讨. 华西医学, 2022, 37(2): 189-193.
13.	杨红梅, 林艳, 刘佩珍, 等. 手术室运营管理中手术排程研究进展. 护理学报, 2021, 28(11): 12-15.
14.	包安竹, 白晓霞, 王小丽, 等. 手术智能排程系统的设计及临床应用. 中华护理杂志, 2018, 53(3): 338-342.
15.	Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284): 473-476.
16.	吕子宁, 刘洋, 梁鹏. 个体化的加速康复外科理念在日归手术麻醉中的应用. 华西医学, 2022, 37(2): 262-266.
17.	刘洋, 李志超, 马洪升. 四川大学华西医院日间手术患者延迟出院原因分析. 中国循证医学杂志, 2016, 16(4): 383-386.
18.	马俊丽, 魏新川. 术后恶心呕吐病因、机制和治疗进展. 实用医院临床杂志, 2022, 19(1): 190-193.
19.	马洪升, 程南生, 朱涛, 等. 华西医院日间手术快速康复(ERAS)规范. 中国胸心血管外科临床杂志, 2016, 23(2): 104-106.
20.	陈潇, 张玉侠, 周海英, 等. 术后恶心呕吐非药物管理的最佳证据总结. 中华护理杂志, 2021, 56(11): 1721-1727.
21.	Pujahari AK. Day care vs overnight stay after laparoscopic cholecystectomy even with co-morbidity and a possible second surgery: a patient’s choice. J Clin Diagn Res, 2016, 10(10): PC25-PC27.
22.	门琤, 郭满, 任静. 甲状腺恶性肿瘤日间手术患者出院准备度及延迟出院情况调查. 临床医学, 2023, 43(6): 54-56.
23.	张晗, 黄明君, 戴燕. 日间手术延迟出院影响因素分析及应对措施. 中国卫生质量管理, 2022, 29(7): 26-31.
24.	马洪升, 蒋丽莎, 刘洋, 等. 快速康复外科理念在日间手术中的实践. 中国普外基础与临床杂志, 2015, 22(11): 1384-1385.
25.	戴燕, 张雨晨. 医院-社区一体化服务模式在日间手术出院患者延续护理中的应用. 中华现代护理杂志, 2018, 24(12): 1369-1371.
26.	贺红, 庹汪阳, 袁华娣, 等. 肺癌患者日间手术后延迟出院的危险因素研究. 中华急危重症护理杂志, 2022, 3(3): 203-207.
27.	邱玲, 刘春香, 朱玮, 等. 泌尿系结石日间手术患者延迟出院的危险因素分析. 中华全科医学, 2021, 19(8): 1265-1268.
28.	余琼, 邓雁, 冯林美. 老年日间手术患者延迟出院的风险预测模型构建. 护理学杂志, 2022, 37(15): 52-55.

1. 安燚, 王振军. 日间手术的概念和基本问题. 中国实用外科杂志, 2007(1): 38-40.
2. 于丽华. 中国日间手术发展的历程与展望. 中国医院管理, 2016, 36(6): 16-18.
3. 雷甜甜, 梁鹏, 马洪升, 等. 四川大学华西医院日归手术管理实践. 广东医学, 2022, 43(10): 1222-1228.
4. Duignan M, Lao C, Lawrenson R, et al. A policy of day-case sinonasal surgery is safe, well tolerated and cost-effective. J Laryngol Otol, 2021, 135(4): 341-343.
5. Mayo BC, Massel DH, Bohl DD, et al. Effect of surgery start time on day of discharge in anterior cervical discectomy and fusion patients. Spine (Phila Pa 1976), 2016, 41(24): 1939-1944.
6. Ganesan S, Prior AJ, Rubin JS. Unexpected overnight admissions following day-case surgery: an analysis of a dedicated ENT day care unit. Ann R Coll Surg Engl, 2000, 82(5): 327-330.
7. Rutledge J, Siegel E, Belcher R, et al. Barriers to same-day discharge of patients undergoing total and completion thyroidectomy. Otolaryngol Head Neck Surg, 2014, 150(5): 770-774.
8. Sultan J, Marflow KZ, Roy B. Unplanned overnight admissions in day-case arthroscopic shoulder surgery. Surgeon, 2012, 10(1): 16-19.
9. Solodkyy A, Hakeem AR, Oswald N, et al. ‘True day case’ laparoscopic cholecystectomy in a high-volume specialist unit and review of factors contributing to unexpected overnight stay. Minim Invasive Surg, 2018, 2018: 1260358.
10. Elder M, Steven D, Beasley S, et al. Unplanned overnight hospital admission after strabismus surgery. N Z Med J, 2007, 120(1260): U2681.
11. Cifarelli CP, McMichael JP, Forman AG, et al. Surgical start time impact on hospital length of stay for elective inpatient procedures. Cureus, 2021, 13(7): e16259.
12. 詹丽莉, 刘洋, 蒋丽莎, 等. 日归模式在日间手术的临床应用与探讨. 华西医学, 2022, 37(2): 189-193.
13. 杨红梅, 林艳, 刘佩珍, 等. 手术室运营管理中手术排程研究进展. 护理学报, 2021, 28(11): 12-15.
14. 包安竹, 白晓霞, 王小丽, 等. 手术智能排程系统的设计及临床应用. 中华护理杂志, 2018, 53(3): 338-342.
15. Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284): 473-476.
16. 吕子宁, 刘洋, 梁鹏. 个体化的加速康复外科理念在日归手术麻醉中的应用. 华西医学, 2022, 37(2): 262-266.
17. 刘洋, 李志超, 马洪升. 四川大学华西医院日间手术患者延迟出院原因分析. 中国循证医学杂志, 2016, 16(4): 383-386.
18. 马俊丽, 魏新川. 术后恶心呕吐病因、机制和治疗进展. 实用医院临床杂志, 2022, 19(1): 190-193.
19. 马洪升, 程南生, 朱涛, 等. 华西医院日间手术快速康复(ERAS)规范. 中国胸心血管外科临床杂志, 2016, 23(2): 104-106.
20. 陈潇, 张玉侠, 周海英, 等. 术后恶心呕吐非药物管理的最佳证据总结. 中华护理杂志, 2021, 56(11): 1721-1727.
21. Pujahari AK. Day care vs overnight stay after laparoscopic cholecystectomy even with co-morbidity and a possible second surgery: a patient’s choice. J Clin Diagn Res, 2016, 10(10): PC25-PC27.
22. 门琤, 郭满, 任静. 甲状腺恶性肿瘤日间手术患者出院准备度及延迟出院情况调查. 临床医学, 2023, 43(6): 54-56.
23. 张晗, 黄明君, 戴燕. 日间手术延迟出院影响因素分析及应对措施. 中国卫生质量管理, 2022, 29(7): 26-31.
24. 马洪升, 蒋丽莎, 刘洋, 等. 快速康复外科理念在日间手术中的实践. 中国普外基础与临床杂志, 2015, 22(11): 1384-1385.
25. 戴燕, 张雨晨. 医院-社区一体化服务模式在日间手术出院患者延续护理中的应用. 中华现代护理杂志, 2018, 24(12): 1369-1371.
26. 贺红, 庹汪阳, 袁华娣, 等. 肺癌患者日间手术后延迟出院的危险因素研究. 中华急危重症护理杂志, 2022, 3(3): 203-207.
27. 邱玲, 刘春香, 朱玮, 等. 泌尿系结石日间手术患者延迟出院的危险因素分析. 中华全科医学, 2021, 19(8): 1265-1268.
28. 余琼, 邓雁, 冯林美. 老年日间手术患者延迟出院的风险预测模型构建. 护理学杂志, 2022, 37(15): 52-55.

West China Medical Journal

Analysis of reasons for unplanned overnight recovery after same-day surgery

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content