Almashari Yasser M, Allarakia Yazeed, Barradah Omar, Alqozi Yazan, Almoraei Abdullah M, Alshaya Rand A, Muawad Rayan
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Pediatric Anesthesia, Ministry of National Guard - Health Affairs, Riyadh, SAU.
Cureus. 2024 May 8;16(5):e59896. doi: 10.7759/cureus.59896. eCollection 2024 May.
Introduction The prevalence of one-day surgery (also known as same-day surgery or outpatient surgery) has been increasing recently among patients and physicians in many countries due to its benefits. The main benefits of one-day surgery are that the patient is not planned to stay overnight before the surgery and can be discharged on the same day of the surgery. The lower cost to the health system can make these surgeries more favorable for both sides. However, unplanned readmission after such surgeries can happen and this has broad implications for patients, their families, and the healthcare system. Therefore, this study primarily aims to identify the incidence of unexpected hospital readmissions following one-day surgery after discharge among children. The study also aims to identify any significant variables that can be identified with the cases of readmissions to allow for further investigations in future studies Methods This study was done at King Abdullah Specialist Children's Hospital in Riyadh, Saudi Arabia. The target population included all pediatric patients who underwent one-day surgeries and were admitted within one week of their discharge from 2017 to 2023 through outpatient clinics and the emergency department. Results The study sample size was 403 patients, with male patients accounting for 241 surgeries (59.8%), and female patients accounting for 162 surgeries (40.1%). The most common American Society of Anesthesiologists (ASA) classification was II, accounting for 169 cases (41.9%). Toddlers and preschoolers (aged 1-6 years) were the age groups with the highest number of patients (n=252, 62.5% combined). Elective surgeries accounted for 382 cases (94.7%). The specialty with the highest number of surgeries was ear, nose, and throat with 284 cases (70.4%) with tonsillectomy with adenoidectomy being the most common surgery with 234 cases (58%). The most common reasons for unplanned readmission were poor oral intake (n=146, 36.2%) and bleeding (n=131, 32.5%). The most common day of readmission was the seventh day in five surgical specialties (45.4%). Conclusion Over the past seven years, 403 patients were readmitted within one week after their one-day surgery at King Abdullah Specialist Children's Hospital. Such a situation may cause dissatisfaction with the medical care that the patients were given and eventually may build an untrusted relationship between the patient and the physician. Future investigations should be established to lower such a condition and develop prevention methods to lower its prevalence.
引言 由于其诸多益处，近年来，一日手术（也称为当日手术或门诊手术）在许多国家的患者和医生中越来越普遍。一日手术的主要益处在于患者在手术前无需计划过夜住院，并且可以在手术当天出院。对医疗系统而言成本较低，这使得此类手术对双方都更具吸引力。然而，此类手术后可能会发生意外再次入院的情况，这对患者及其家属以及医疗系统都有广泛影响。因此，本研究主要旨在确定儿童一日手术后出院后意外再次入院的发生率。该研究还旨在确定与再次入院病例相关的任何显著变量，以便在未来研究中进行进一步调查。
方法 本研究在沙特阿拉伯利雅得的阿卜杜拉国王专科医院进行。目标人群包括2017年至2023年期间通过门诊和急诊科接受一日手术并在出院后一周内入院的所有儿科患者。
结果 研究样本量为403例患者，其中男性患者占241例手术（59.8%），女性患者占162例手术（40.1%）。最常见的美国麻醉医师协会（ASA）分级为II级，占169例（41.9%）。幼儿和学龄前儿童（1至6岁）是患者数量最多的年龄组（n = 252，合计62.5%）。择期手术占382例（94.7%）。手术数量最多的专科是耳鼻喉科，有284例（70.4%），其中扁桃体切除术加腺样体切除术是最常见的手术，有234例（58%）。计划外再次入院的最常见原因是经口摄入量少（n = 146，36.2%）和出血（n = 131，32.5%）。再次入院最常见的日期是五个外科专科中的第七天（45.4%）。
结论 在过去七年中，阿卜杜拉国王专科医院有403例患者在一日手术后一周内再次入院。这种情况可能会导致患者对所接受的医疗护理不满意，并最终可能在患者和医生之间建立起不信任的关系。应开展未来调查以降低这种情况的发生率，并制定预防方法以降低其患病率。
