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Tytuł pozycji:

Predictors of prolonged admission after outpatient female pelvic reconstructive surgery.

Tytuł:
Predictors of prolonged admission after outpatient female pelvic reconstructive surgery.
Autorzy:
Simi AM; Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Chapman GC; Division of Urogynecology and Pelvic Floor Disorders, Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Zillioux J; Department of Urology, Glickman Urological and Kidney Institute, Center for Female Pelvic Medicine and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Martin S; Department of Urology, Glickman Urological and Kidney Institute, Center for Female Pelvic Medicine and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Slopnick EA; Department of Urology, Glickman Urological and Kidney Institute, Center for Female Pelvic Medicine and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Źródło:
Neurourology and urodynamics [Neurourol Urodyn] 2022 Apr; Vol. 41 (4), pp. 1031-1040. Date of Electronic Publication: 2022 Mar 29.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Original Publication: New York : Alan R. Liss, c1982-
MeSH Terms:
Outpatients*
Plastic Surgery Procedures*/methods
Female ; Humans ; Length of Stay ; Male ; Patient Readmission ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies
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Contributed Indexing:
Keywords: ambulatory surgical procedures; frailty; length of stay; pelvic floor disorders; pelvic organ prolapse; reconstructive surgical procedures
Entry Date(s):
Date Created: 20220329 Date Completed: 20220429 Latest Revision: 20221207
Update Code:
20240104
PubMed Central ID:
PMC9314950
DOI:
10.1002/nau.24924
PMID:
35347748
Czasopismo naukowe
Objectives: This study aimed to determine factors associated with prolonged hospital admission following outpatient female pelvic reconstructive surgery (FPRS) and associated adverse clinical outcomes.
Methods: Using the National Surgical Quality Improvement Program database, we identified outpatient FPRS performed 2011-2016. Isolated hysterectomy without concurrent prolapse repair was excluded. Surgeries were classified as major or minor for analysis. The primary outcome was prolonged length of stay (LOS), defined as admission of ≥2 days. Secondary outcomes included complications, readmission and reoperation associated with prolonged LOS. We abstracted data on covariates, and following univariable analysis, performed backward stepwise regression analysis.
Results: A total of 29645 women were included: 12311 (41.5%) major and 17334 (58.5%) minor procedures. A total of 6.9% (2033) had a prolonged LOS. On full cohort multivariable regression analysis, patient characteristics associated with prolonged LOS were older age (odds ratio [OR]: 1.1 per 10 years, confidence interval [CI]: 1.06-1.1, p < 0.001), frailty (OR: 1.8, 95% CI: 1.3-2.6, p = 0.001), and Caucasian race (OR: 1.2, CI: 1.02-1.3, p = 0.024). Associated surgical factors included having a major surgical procedure (OR: 1.3, CI: 1.2-1.4, p < 0.001), use of general anesthesia (OR: 2.0, CI: 1.5-2.6, p < 0.001) and longer operative time (OR: 2.0, CI: 1.8-2.2, p < 0.001). The occurrence of any complication (10.3% vs. 4.7%, p < 0.001), hospital readmission (4.3% vs. 1.7%, p < 0.001), and reoperation (2.7% vs. 1.0%, p < 0.001) were more likely with prolonged LOS.
Conclusions: After outpatient FPRS, 6.9% of patients experience an admission of ≥2 days. Prolonged LOS is more common in patients who are older, frail and Caucasian, and in those who have major surgery with long operative time and general anesthesia.
(© 2022 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC.)

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