Department of Anesthesiology and Intensive Care Medicine, Jorvi Hospital, Helsinki University Hospital, Espoo, Finland.
Am J Surg. 2011 Feb;201(2):179-85. doi: 10.1016/j.amjsurg.2010.04.024.
There is a lack of evidence from randomized studies of the feasibility of ambulatory surgery in patients aged 65 years and older.
Medically stable patients scheduled for open inguinal hernia repair, with postoperative care available at home, were randomized to receive treatment either as outpatients or inpatients. Younger patients undergoing the same procedure served as a reference group. Outcome measures during the 2 weeks after surgery were complications, unplanned admissions, visits to the hospital, unplanned visits to primary health care, and patients' acceptance of the type of provided care.
Of 151 patients, 89 were included. Main reasons for exclusion were lack of postoperative company (16%), unwillingness to participate (13%), and medical conditions (10%). All outpatients were discharged home as planned, and none of the study patients were readmitted to the hospital. Patient satisfaction was high with no differences between the groups.
Ambulatory surgery was safe and well accepted by older, medically stable patients.
缺乏 65 岁及以上患者日间手术可行性的随机研究证据。
接受择期开放式腹股沟疝修补术且术后可在家庭中得到护理的病情稳定的患者被随机分配为门诊或住院治疗。接受相同手术的年轻患者作为参考组。术后 2 周内的结果测量包括并发症、非计划入院、就诊次数、对初级保健的非计划就诊以及患者对所提供护理类型的接受程度。
151 名患者中,89 名患者被纳入研究。排除的主要原因是术后无人陪伴(16%)、不愿意参与(13%)和医疗状况(10%)。所有门诊患者均按计划出院,无研究患者再次住院。患者满意度高,两组间无差异。
日间手术对病情稳定的老年患者是安全且可接受的。