Lee Linda N, Quatela Olivia, Bhattacharyya Neil
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.
Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Laryngoscope. 2018 Dec;128(12):2714-2717. doi: 10.1002/lary.27220. Epub 2018 Sep 8.
OBJECTIVES/HYPOTHESIS: To determine 30-day rates and reasons for revisit and readmission after rhytidectomy surgery.
Cross-sectional analysis.
Cross-sectional analysis was performed of multistate ambulatory surgery and hospital databases. Ambulatory rhytidectomy cases were extracted from State Ambulatory Surgery Databases for New York, Florida, Iowa, and California for 2010 and 2011. Cases were linked to State Emergency Department and Inpatient Databases for visits occurring 1 to 30 days postoperatively.
A total of 6,089 rhytidectomy cases were extracted (87.9% female). The mean age was 61.1 years, and the most common age group was 61 to 70 years (40.2%), followed by 51 to 60 years (33.2%), and 71 to 80 years (12.0%). Overall, 3.6% of patients had a revisit after surgery (42.7% to an ambulatory surgery center, 42.2% to an emergency department, and 15.1% to inpatient admission). The most common primary diagnoses at the time of the revisit were hematoma (17.0%), fever/nausea/diarrhea (4.1%), and urinary tract infection (4.1%).
Rhytidectomy is performed to treat facial aging, and can provide surgical outcomes which may not be achievable with nonsurgical alternatives. The 30-day revisit and readmission rate for this procedure in a large multistate cohort has not previously been reported. The revisit rate is low after rhytidectomy, and the most common reason for revisit is hematoma. These data provide important insight to optimize perioperative management and decrease postoperative revisits. This study does not capture return visits to the physician's office; however, postoperative issues that require presentation to outside facilities are important to distinguish from those managed in the practitioner's office, because they may incur additional, unplanned cost to both the patient and the healthcare system.
NA Laryngoscope, 128:2714-2717, 2018.
目的/假设:确定除皱手术后30天内再次就诊及再入院的发生率和原因。
横断面分析。
对多州门诊手术和医院数据库进行横断面分析。从纽约州、佛罗里达州、爱荷华州和加利福尼亚州的州门诊手术数据库中提取2010年和2011年的门诊除皱手术病例。将这些病例与术后1至30天内就诊的州急诊科和住院数据库进行关联。
共提取了6089例除皱手术病例(87.9%为女性)。平均年龄为61.1岁,最常见的年龄组为61至70岁(40.2%),其次是51至60岁(33.2%)和71至80岁(12.0%)。总体而言,3.6%的患者术后再次就诊(42.7%至门诊手术中心,42.2%至急诊科,15.1%至住院治疗)。再次就诊时最常见的主要诊断为血肿(17.0%)、发热/恶心/腹泻(4.1%)和尿路感染(4.1%)。
除皱手术用于治疗面部衰老,可提供非手术替代方法无法实现的手术效果。此前尚未报道过大型多州队列中该手术的30天再次就诊及再入院率。除皱手术后再次就诊率较低,最常见的再次就诊原因是血肿。这些数据为优化围手术期管理和减少术后再次就诊提供了重要见解。本研究未涵盖返回医生办公室的复诊情况;然而,需要到外部机构就诊的术后问题对于区分在医生办公室处理的问题很重要,因为它们可能给患者和医疗系统带来额外的意外费用。
NA 《喉镜》,2018年,第128卷,第2714 - 2717页