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日间手术安全吗?丹麦 57709 例日间手术术后发病率的多中心研究。

Is day surgery safe? A Danish multicentre study of morbidity after 57,709 day surgery procedures.

机构信息

Department of Anaesthesiology and Intensive Care Medicine, Copenhagen University Hospital, Herlev, Denmark.

出版信息

Acta Anaesthesiol Scand. 2012 Mar;56(3):323-31. doi: 10.1111/j.1399-6576.2011.02631.x.

Abstract

BACKGROUND

Day surgery is expanding in several countries, and it is important to collect information about quality. The aim of this study was to assess morbidity and unanticipated hospital visits 0-30 days post-operatively in a large cohort.

METHODS

We prospectively recorded data from 57,709 day surgery procedures performed in eight day surgery centres over a 3-year period. We cross-checked with the National Patient Registry to identify complications 0-30 days post-operatively, and registrations from The Danish Register of Cause of Death were requested. We retrieved the records of 1174 patients to assign a relation between secondary contact and day surgery.

RESULTS

The overall rate of return hospital visits was 1.21% [95% confidence interval (CI): 1.12-1.30%] caused by a wide range of diagnoses. No deaths were definitely related to day surgery. The return hospital visits were due to haemorrhage/haematoma 0.50% (95% CI: 0.44-0.56%), infection 0.44% (95% CI: 0.38-0 49%) and thromboembolic events 0.03%. Major morbidity was rare. The surgical procedures with the highest rate of complication were tonsillectomies 11.4%, surgically induced abortions 3.13% and inguinal hernia repairs 1.23%.

CONCLUSION

This large-scale Danish national study confirmed that day surgery is associated with a very low rate of return hospital visits. Despite the rapid expansion of day surgery, safety has been maintained, major morbidity being very rare, and no deaths being definitely related to day surgery.

摘要

背景

日间手术在多个国家不断扩展,收集相关质量信息十分重要。本研究旨在评估在一个大型队列中,术后 0-30 天内的发病率和意外医院就诊情况。

方法

我们前瞻性地记录了在三年内于 8 个日间手术中心进行的 57709 例日间手术程序的数据。我们与国家患者登记处交叉核对术后 0-30 天内的并发症,并要求丹麦死因登记处提供登记信息。我们检索了 1174 名患者的记录,以确定二次就诊与日间手术之间的关系。

结果

总的术后复诊率为 1.21%[95%置信区间(CI):1.12-1.30%],原因包括广泛的诊断。无死亡病例与日间手术有明确关联。术后复诊的原因是出血/血肿 0.50%(95%CI:0.44-0.56%)、感染 0.44%(95%CI:0.38-0.49%)和血栓栓塞事件 0.03%。严重发病率罕见。并发症发生率最高的手术是扁桃体切除术 11.4%、手术流产 3.13%和腹股沟疝修补术 1.23%。

结论

这项大规模的丹麦全国性研究证实,日间手术与极低的术后复诊率相关。尽管日间手术迅速扩展,但安全性得以维持,严重发病率非常罕见,且无死亡病例与日间手术有明确关联。

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