Factors that Lengthen Patient Hospitalizations Following Laparoscopic Hysterectomy.

Szczegóły
Abstrakt

Tytuł:: Factors that Lengthen Patient Hospitalizations Following Laparoscopic Hysterectomy.
Autorzy:: Ramirez-Caban L; Emory University Health System, Atlanta, GA, USA.
Kannan A; Emory University Health System, Atlanta, GA, USA.
Goggins ER; Emory University Health System, Atlanta, GA, USA.
Shockley ME; Emory University Health System, Atlanta, GA, USA.
Haddad LB; Emory University Health System, Atlanta, GA, USA.
Chahine EB; Emory University Health System, Atlanta, GA, USA.
Źródło:: JSLS : Journal of the Society of Laparoendoscopic Surgeons [JSLS] 2020 Jul-Sep; Vol. 24 (3).
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Miami, FL : Society of Laparoscopic & Robotic Surgeons
Original Publication: Miami, FL : The Society, c1997-
MeSH Terms:: Hysterectomy/*methods
Laparoscopy/*methods
Length of Stay/*statistics & numerical data
Robotic Surgical Procedures/*methods
Adolescent ; Adult ; Aged ; Enhanced Recovery After Surgery ; Female ; Humans ; Hysterectomy, Vaginal/methods ; Logistic Models ; Middle Aged ; Outcome Assessment, Health Care ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Retrospective Studies ; Risk Factors ; Young Adult
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Contributed Indexing:: Keywords: Hysterectomy; Laparoscopy; Length of stay; Prolonged hospitalization
Entry Date(s):: Date Created: 20200728 Date Completed: 20210120 Latest Revision: 20220415
Update Code:: 20240105
PubMed Central ID:: PMC7362931
DOI:: 10.4293/JSLS.2020.00029
PMID:: 32714003
: Czasopismo naukowe

Objective: To establish descriptive observations associated with prolonged hospitalization after laparoscopic hysterectomy prior to the implementation of a department-wide Enhanced Recovery After Surgery protocol.
Methods: A retrospective cohort study at three academic affiliated hospitals in the southeastern United States was conducted evaluating length of hospitalization by patient, surgical, and physician factors for 384 patients who underwent total laparoscopic hysterectomy, laparoscopic assisted vaginal hysterectomy, and robotic assisted total laparoscopic hysterectomy for benign conditions by general and subspecialized gynecologists from 2010 to 2015.
Results: Among 384 patients, 19.5% experienced prolonged hospitalization, defined as greater than one day. After adjusting for covariates, robotic assisted total laparoscopic hysterectomy (aOR 3.13), dietary restrictions on postoperative day 1 (aOR 4.42), postoperative nausea or vomiting (aOR 2.01), and postoperative complications (aOR 3.58) were associated with prolonged hospitalization.
Conclusion: Data from this study were collected prior to implementation of department-wide enhanced recovery after surgery protocols and highlights areas for improvement. Implementation of specific aspects of these protocols, including aggressive prevention of postoperative nausea and vomiting and early feeding, are easily made changes which may help to effectively decrease length of stay after laparoscopic hysterectomy. Patient and provider education on enhanced recovery protocols is also key to reducing length of stay.
Competing Interests: Conflicts of Interest: The authors have no conflicts of interest directly relevant to the content of this article.
(© 2020 by JSLS, Journal of the Society of Laparoscopic & Robotic Surgeons.)

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