Albabtain Ibrahim T, Alsuhaibani Roaa S, Almalki Sami A, Arishi Hassan A, Alsulaim Hatim A
Dr. Sami Abdulrahman Almalki, College of Medicine,, King Saud bin Abdulaziz University for Health Sciences,, PO Box 6247, Riyadh 12936,, Saudi Arabia, T: +966555987922,
Ann Saudi Med. 2018 Mar-Apr;38(2):105-110. doi: 10.5144/0256-4947.2018.105.
Hospitals usually reduce staffing levels and services over weekends. This raises the question of whether patients discharged over a weekend may be inadequately prepared and possibly at higher risk of adverse events post-discharge.
To assess the outcomes of common general surgery procedures for patients discharged over weekends, and to identify the key predictors of early readmission.
Retrospective cohort study.
A tertiary care center.
Patients discharged from general surgery services during the one-year period between January and December 2016 after cholecystectomy, appendectomy, or hernia repairs were included. Patient demographic information, comorbidities, and complications as well as admission and follow-up details were collected from electronic medical records.
Outcomes following weekend discharge, and the predictors of early readmission.
743 patients.
The operations performed: 361 patients (48.6%) underwent a cholecystectomy, 288 (38.8%) an appendectomy, and 94 (12.6%) hernia repairs. A significantly lower number of patients were discharged over the weekend (n=125) compared to those discharged on weekdays (n=618). Patients discharged during the weekend were younger, less likely to have chronic diseases, and had a significantly shorter average length of stay (LOS) (median 2 days, IQR: 1, 4 vs. median 3 days, IQR: 1, 5, P=.002). Overall, the 30-day readmission rate was 3.2% (n=24), and weekend discharge (OR=2.25, 95% CI 0.52-9.70) or any other variable did not predict readmission in 30 days. However, 14-day post-discharge follow-up visits were significantly lower in the weekend discharge subgroup (83.1% vs. 91.2%, P=.006).
Weekend discharge was not associated with higher readmission rates. Physicians may consider discharging post-operative patients over a weekend without an increased risk to the patient. Day of discharge, length of stay and increased patient age are not predictors of early readmission.
Single-center study and retrospective.
None.
医院通常会在周末减少人员配备和服务。这就引发了一个问题，即周末出院的患者是否准备不足，出院后发生不良事件的风险是否可能更高。
评估周末出院的普通外科常见手术患者的结局，并确定早期再入院的关键预测因素。
回顾性队列研究。
一家三级医疗中心。
纳入2016年1月至12月期间因胆囊切除术、阑尾切除术或疝气修补术后从普通外科出院的患者。从电子病历中收集患者的人口统计学信息、合并症、并发症以及入院和随访细节。
周末出院后的结局以及早期再入院的预测因素。
743例患者。
所实施的手术：361例患者（48.6%）接受了胆囊切除术，288例（38.8%）接受了阑尾切除术，94例（12.6%）接受了疝气修补术。与工作日出院的患者（n = 618）相比，周末出院的患者数量显著较少（n = 125）。周末出院的患者更年轻，患慢性病的可能性更小，平均住院时间（LOS）显著更短（中位数2天，四分位间距：1，4天 vs. 中位数3天，四分位间距：1，5天，P = 0.002）。总体而言，30天再入院率为3.2%（n = 24），周末出院（比值比 = 2.25，95%置信区间0.52 - 9.70）或任何其他变量均不能预测30天内的再入院情况。然而，周末出院亚组出院后14天的随访就诊率显著较低（83.1%对91.2%，P = 0.006）。
周末出院与较高的再入院率无关。医生可以考虑在周末让术后患者出院，而不会增加患者风险。出院日期、住院时间和患者年龄增加并非早期再入院的预测因素。
单中心研究且为回顾性研究。
无。
