Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio.
Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio.
J Minim Invasive Gynecol. 2018 Mar-Apr;25(3):484-490. doi: 10.1016/j.jmig.2017.10.013. Epub 2017 Oct 14.
To determine if there is a difference in readmission rates after same-day discharge compared with postoperative day 1 discharges after laparoscopic hysterectomy.
A retrospective cohort study with 1:2 propensity score matching (Canadian Task Force classification II-2).
American College of Surgeons National Surgical Quality Improvement Program database.
Women undergoing benign laparoscopic total or supracervical hysterectomy or laparoscopic-assisted vaginal hysterectomy with or without adnexal surgery between the years 2010 to 2015.
Three thousand thirty-two low-risk women discharged on postoperative day 0 and 6064 women discharged on postoperative day 1 were included in the analysis.
The overall readmission rate was 1.8%; after same-day discharge, the readmission rate was 2.2%, and after postoperative day 1 discharge the readmission rate was 1.7% (p = .10). After logistic regression analysis, smoking (adjusted odds ratio [aOR] = 2.06; 95% confidence interval [CI], 1.49-2.88), nonwhite race (aOR = 1.53; 95% CI, 1.1007-2.14), and cystoscopy (aOR = 2.05; 95% CI, 1.49-2.82) were associated with an increased risk of readmission.
There was no statistically significant difference in readmission rates after laparoscopic hysterectomy between women discharged on the day of surgery or postoperative day 1.
确定与术后第一天出院相比，腹腔镜子宫切除术后当天出院的再入院率是否存在差异。
回顾性队列研究，采用 1:2 倾向评分匹配（加拿大外科医师学会分类 II-2）。
美国外科医师学会国家手术质量改进计划数据库。
2010 年至 2015 年间接受良性腹腔镜全子宫切除术或经宫颈子宫切除术或腹腔镜辅助阴道子宫切除术，伴或不伴附件手术的女性。
分析纳入了 3032 名在术后第 0 天出院的低危女性和 6064 名在术后第 1 天出院的女性。
总体再入院率为 1.8%；当天出院后，再入院率为 2.2%，术后第 1 天出院后，再入院率为 1.7%（p=0.10）。经过逻辑回归分析，吸烟（调整后优势比[aOR] = 2.06；95%置信区间[CI]，1.49-2.88）、非白人种族（aOR = 1.53；95%CI，1.1007-2.14）和膀胱镜检查（aOR = 2.05；95%CI，1.49-2.82）与再入院风险增加相关。
腹腔镜子宫切除术后当天出院与术后第 1 天出院的女性在再入院率方面无统计学显著差异。
