Evaluation of day surgery <i>versus</i> inpatient surgery for varicose vein in China: a retrospective study based on propensity score matching method_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Mingjun ^1,2 , JIANG Jingwen ³ ,  DAI Yan ¹ , MA Hongsheng ¹ , ZHAO Jichun ⁴

1. Day Surgery Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Nursing in Sichuan University, Chengdu 610041, P. R. China;
3. Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
4. Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

DAI Yan, Email: 1846703501@qq.com

Keywords：

varicose vein; day surgery; inpatient surgery; propensity score matching

DOI：

10.7507/1007-9424.202004106

Video：

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Objective To compare the intraoperative, postoperative indicators and economic costs of varicose veins patients between day surgery and inpatient surgery, and to explore the safety and benefit of large-scale varicose veins day surgery in China.Methods A retrospective study was conducted to collect varicose veins patients in West China Hospital of Sichuan University from January 2016 to January 2019. Patients were divided into the day surgery group and the inpatient surgery group, and the subjects were matched by the propensity score matching (PSM) method according to the basic characteristic data. Intraoperative and postoperative indicators and economic costs were compared between the two groups.Results A total of 1 806 varicose vein patients were enrolled in the study, and 502 patients were enrolled in each of the two groups after PSM matching. After matching, there were no statistically significant differences in gender, age, nationality, marriage status, working status, residence, number of operative legs, medical insurance type, grade of American Society of Anesthesiologists, and complications (including hypertension, diabetes, coronary heart disease, and respiratory system diseases) between the two groups (P>0.05), which were comparable and the differences were not statistically significant. Compared with the inpatient surgery group, the day surgery group had shorter hospital stay, less intraoperative infusion volume, lower total cost, bed cost, nursing cost, drug cost, examination cost, medical insurance, and out-of-pocket (P<0.05). Conclusion The varicose veins day surgery is not only safe and effective, but also can reduce the medication insurance payment.

Citation： HUANG Mingjun, JIANG Jingwen, DAI Yan, MA Hongsheng, ZHAO Jichun. Evaluation of day surgery versus inpatient surgery for varicose vein in China: a retrospective study based on propensity score matching method. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(1): 58-62. doi: 10.7507/1007-9424.202004106 Copy

1.	DePopas E, Brown M. Varicose veins and lower extremity venous insufficiency. Semin Intervent Radiol, 2018, 35(1): 56-61.
2.	Nagpal K, Glore RJ, Chong PL, et al. Day-case re-do varicose vein surgery. Phlebology, 2014, 29(6): 355-357.
3.	Zhang M, Qiu T, Bu X, et al. A national survey on management of varicose veins in China. J Vasc Surg Venous Lymphat Disord, 2018, 6(3): 338-346.
4.	Bailey CR, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019: Guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesthesia, 2019, 74(6): 778-792.
5.	刘思, 吴洲鹏, 罗艳丽. 开展大隐静脉曲张剥脱术日间病房运营模式的可行性探讨. 中国普外基础与临床杂志, 2012, 19(10): 1110-1113.
6.	Hamdan A. Management of varicose veins and venous insufficiency. JAMA, 2012, 308(24): 2612-2621.
7.	吴洲鹏, 赵纪春, 黄斌, 等. 日间单侧与双侧大隐静脉曲张手术并发症的对比分析. 中国医师杂志, 2014, 16(7): 868-870.
8.	陆黎, 陆炯, 夏成勇, 等. 大隐静脉射频消融术与大隐静脉高位结扎剥脱术治疗静脉曲张的疗效对比. 局解手术学杂志, 2020, 29(1): 38-42.
9.	刘洪, 赵渝. 下肢静脉曲张微创治疗现状. 中国普外基础与临床杂志, 2020, 27(4): 400-403.
10.	官云彪. 下肢静脉曲张的常用治疗方法. 中华普通外科学文献(电子版), 2020, 14(1): 1-4.
11.	曾彦彰, 杨轶, 赵纪春. 大隐静脉结扎剥脱联合泡沫硬化剂与单纯泡沫硬化剂治疗下肢静脉性溃疡的疗效比较. 中国普外基础与临床杂志, 2018, 25(3): 312-316.
12.	廖懿, 赵纪春. 高位结扎加点式剥脱术治疗原发性大隐静脉曲张的最佳时机. 中国普外基础与临床杂志, 2016, 23(2): 198-200.
13.	俞德梁, 刘小南, 宁鹏涛. 中国日间手术政策演变及对医疗决策发展的启示. 医学与哲学, 2016, 37(12): 4-7.
14.	孙博, 刘雷, 王东光. 国内日间手术发展进程、存在问题与对策建议. 中国卫生质量管理, 2018, 25(5): 17-20.
15.	Xiong Y, Xu Q, Wang Y, et al. Day surgery is effective and safe for patients with great saphenous vein varices who meet American Society of Anesthesiologists Ⅰ–Ⅱ grading. Niger J Clin Pract, 2016, 19(4): 455-459.
16.	Rivlin E, Haddad M, Landau O, et al. Bilateral versus unilateral high ligation and stripping of the greater saphenous vein for varicose veins. Vasa, 1991, 20(3): 267-269.
17.	Bunnell AP, Zaidi S, Eidson JL 3rd, et al. Factors associated with saphenous vein recanalization after endothermal ablation. Ann Vasc Surg, 2015, 29(2): 322-327.
18.	吉浩, 谢颖夫, 刘灵, 等. 日间手术中心运行对住院医疗费用的影响分析. 中国继续医学教育, 2018, 10(29): 72-73.
19.	Walsh MT. Improving outcomes in ambulatory anesthesia by identifying high risk patients. Curr Opin Anaesthesiol, 2018, 31(6): 659-666.
20.	Anwar MA, Lane TR, Davies AH, et al. Complications of radiofrequency ablation of varicose veins. Phlebology, 2012, 27(Suppl 1): 34-39.
21.	Lapage KG, Wouters PF. The patient with hypertension undergoing surgery. Curr Opin Anaesthesiol, 2016, 29(3): 397-402.
22.	Zhuang M, Fan W, Xie P, et al. Evaluation of the safety and quality of day-case cataract surgery based on 4 151 cases. Int J Ophthalmol, 2019, 12(2): 291-295.
23.	Derks LS, Wegner I, Smit AL, et al. Effect of day-case unilateral cochlear implantation in adults on general and disease-specific quality of life, postoperative complications and hearing results, tinnitus, vertigo and cost-effectiveness: protocol for a randomised controlled trial. BMJ Open, 2016, 6(10): e012219.
24.	Kelly MP, Calkins TE, Culvern C, et al. Inpatient versus outpatient hip and knee arthroplasty: which has higher patient satisfaction? J Arthroplasty, 2018, 33(11): 3402-3406.

1. DePopas E, Brown M. Varicose veins and lower extremity venous insufficiency. Semin Intervent Radiol, 2018, 35(1): 56-61.
2. Nagpal K, Glore RJ, Chong PL, et al. Day-case re-do varicose vein surgery. Phlebology, 2014, 29(6): 355-357.
3. Zhang M, Qiu T, Bu X, et al. A national survey on management of varicose veins in China. J Vasc Surg Venous Lymphat Disord, 2018, 6(3): 338-346.
4. Bailey CR, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019: Guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesthesia, 2019, 74(6): 778-792.
5. 刘思, 吴洲鹏, 罗艳丽. 开展大隐静脉曲张剥脱术日间病房运营模式的可行性探讨. 中国普外基础与临床杂志, 2012, 19(10): 1110-1113.
6. Hamdan A. Management of varicose veins and venous insufficiency. JAMA, 2012, 308(24): 2612-2621.
7. 吴洲鹏, 赵纪春, 黄斌, 等. 日间单侧与双侧大隐静脉曲张手术并发症的对比分析. 中国医师杂志, 2014, 16(7): 868-870.
8. 陆黎, 陆炯, 夏成勇, 等. 大隐静脉射频消融术与大隐静脉高位结扎剥脱术治疗静脉曲张的疗效对比. 局解手术学杂志, 2020, 29(1): 38-42.
9. 刘洪, 赵渝. 下肢静脉曲张微创治疗现状. 中国普外基础与临床杂志, 2020, 27(4): 400-403.
10. 官云彪. 下肢静脉曲张的常用治疗方法. 中华普通外科学文献(电子版), 2020, 14(1): 1-4.
11. 曾彦彰, 杨轶, 赵纪春. 大隐静脉结扎剥脱联合泡沫硬化剂与单纯泡沫硬化剂治疗下肢静脉性溃疡的疗效比较. 中国普外基础与临床杂志, 2018, 25(3): 312-316.
12. 廖懿, 赵纪春. 高位结扎加点式剥脱术治疗原发性大隐静脉曲张的最佳时机. 中国普外基础与临床杂志, 2016, 23(2): 198-200.
13. 俞德梁, 刘小南, 宁鹏涛. 中国日间手术政策演变及对医疗决策发展的启示. 医学与哲学, 2016, 37(12): 4-7.
14. 孙博, 刘雷, 王东光. 国内日间手术发展进程、存在问题与对策建议. 中国卫生质量管理, 2018, 25(5): 17-20.
15. Xiong Y, Xu Q, Wang Y, et al. Day surgery is effective and safe for patients with great saphenous vein varices who meet American Society of Anesthesiologists Ⅰ–Ⅱ grading. Niger J Clin Pract, 2016, 19(4): 455-459.
16. Rivlin E, Haddad M, Landau O, et al. Bilateral versus unilateral high ligation and stripping of the greater saphenous vein for varicose veins. Vasa, 1991, 20(3): 267-269.
17. Bunnell AP, Zaidi S, Eidson JL 3rd, et al. Factors associated with saphenous vein recanalization after endothermal ablation. Ann Vasc Surg, 2015, 29(2): 322-327.
18. 吉浩, 谢颖夫, 刘灵, 等. 日间手术中心运行对住院医疗费用的影响分析. 中国继续医学教育, 2018, 10(29): 72-73.
19. Walsh MT. Improving outcomes in ambulatory anesthesia by identifying high risk patients. Curr Opin Anaesthesiol, 2018, 31(6): 659-666.
20. Anwar MA, Lane TR, Davies AH, et al. Complications of radiofrequency ablation of varicose veins. Phlebology, 2012, 27(Suppl 1): 34-39.
21. Lapage KG, Wouters PF. The patient with hypertension undergoing surgery. Curr Opin Anaesthesiol, 2016, 29(3): 397-402.
22. Zhuang M, Fan W, Xie P, et al. Evaluation of the safety and quality of day-case cataract surgery based on 4 151 cases. Int J Ophthalmol, 2019, 12(2): 291-295.
23. Derks LS, Wegner I, Smit AL, et al. Effect of day-case unilateral cochlear implantation in adults on general and disease-specific quality of life, postoperative complications and hearing results, tinnitus, vertigo and cost-effectiveness: protocol for a randomised controlled trial. BMJ Open, 2016, 6(10): e012219.
24. Kelly MP, Calkins TE, Culvern C, et al. Inpatient versus outpatient hip and knee arthroplasty: which has higher patient satisfaction? J Arthroplasty, 2018, 33(11): 3402-3406.

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Evaluation of day surgery versus inpatient surgery for varicose vein in China: a retrospective study based on propensity score matching method

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