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一家三级护理医院日间手术的结果:一项纵向研究。

Outcomes of Day Care Surgery in a Tertiary Care Hospital: A Longitudinal Study.

作者信息

Bhole Sagarika S, Shah Mohd Yunus, Agarwal Unmay

机构信息

General Surgery, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, IND.

出版信息

Cureus. 2025 Aug 11;17(8):e89798. doi: 10.7759/cureus.89798. eCollection 2025 Aug.

Abstract

Background Day care surgery offers a cost-effective and efficient alternative to inpatient care, reducing hospital bed occupancy, postoperative complications, and patient inconvenience. In India, its uptake remains limited, particularly in government hospitals. This study evaluates the feasibility, safety, outcomes, and patient satisfaction of day care surgeries in a tertiary care setting. Methodology A prospective, longitudinal study was conducted from November 2022 to October 2024 at a tertiary care academic hospital in Central India. In total, 86 patients, aged 1-90 years, who met the predefined inclusion criteria, underwent various minor and intermediate surgical procedures. Preoperative anesthesia clearance and informed consent were obtained. Postoperative outcomes were assessed using the ASEPSIS score and Visual Analogue Scale on postoperative days (PODs) 3, 7, and 15. Complications, readmissions, and patient satisfaction (Likert scale) were recorded. Data were analyzed using descriptive statistics and Pearson's chi-square test using Epi Info version 7. Results The mean patient age was 31.24 ± 11.54 years, with a male predominance (72.94%). Spinal anesthesia (51.76%) was the most common, followed by local anesthesia (37.64%). Hernia repair (20.93%) was the most frequently performed procedure. The mean hospital stay was 20.5 ± 2.4 hours. Common complications included postoperative nausea and vomiting (25.88%) and urinary retention (3.52%). By POD 15, 83.72% of patients were pain-free, and 93.02% demonstrated satisfactory wound healing. Readmission occurred in 8.14% of cases, primarily due to urinary retention, uncontrolled pain, or vomiting. Patient satisfaction was high, with 94.12% rating the experience as satisfactory or very satisfactory. Conclusions Day care surgery is a safe, effective, and patient-friendly approach in a tertiary care setting, achieving low complication and readmission rates with high satisfaction. With proper patient selection and structured perioperative protocols, it can optimize resource utilization and improve surgical care delivery in resource-constrained healthcare systems.

摘要

背景 日间手术为住院治疗提供了一种经济高效的替代方案,可减少医院床位占用、术后并发症以及给患者带来的不便。在印度,其应用仍然有限,尤其是在政府医院。本研究评估了三级医疗机构中日间手术的可行性、安全性、结果及患者满意度。

方法 2022年11月至2024年10月在印度中部一家三级医疗学术医院进行了一项前瞻性纵向研究。共有86例年龄在1至90岁之间、符合预定义纳入标准的患者接受了各种小型和中型外科手术。获得了术前麻醉许可和知情同意书。术后第3天、第7天和第15天使用ASEPSIS评分和视觉模拟量表评估术后结果。记录并发症、再次入院情况和患者满意度(李克特量表)。使用描述性统计和Epi Info 7版本的Pearson卡方检验对数据进行分析。

结果 患者平均年龄为31.24±11.54岁,男性占主导(72.94%)。脊髓麻醉(51.76%)最为常见,其次是局部麻醉(37.64%)。疝气修补术(20.93%)是最常进行的手术。平均住院时间为20.5±2.4小时。常见并发症包括术后恶心和呕吐(25.88%)以及尿潴留(3.52%)。到术后第15天,83.72%的患者无疼痛,93.02%的患者伤口愈合情况令人满意。8.14%的病例出现再次入院,主要原因是尿潴留、疼痛控制不佳或呕吐。患者满意度较高,94.12%的患者将此次经历评为满意或非常满意。

结论 在三级医疗机构中,日间手术是一种安全、有效且对患者友好的方法,并发症和再次入院率低,满意度高。通过适当的患者选择和结构化的围手术期方案,它可以优化资源利用,并改善资源有限的医疗系统中的手术护理服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73c1/12421943/855eb4247274/cureus-0017-00000089798-i01.jpg

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