Canady J W, Glowacki R, Thompson S A, Morris H L
Department of Surgery, University of Iowa, Iowa City.
Ann Plast Surg. 1994 Dec;33(6):576-80. doi: 10.1097/00000637-199412000-00002.
With increasing focus on outcome studies, there is continued need for data about whether same-day admission and reduced hospital stay have adverse effects on surgical treatment, including that for cleft lip and palate. In this study, medical records were inspected for all cleft lip and palate patients, aged 1 to 6 years, who had primary palatoplasty or cleft lip/palate revision in this treatment center between 1978 and 1992 (N = 329). Length of stay for 251 (96.5%) of the 260 subjects admitted the day before surgery was from 4 to 7 days; 9 remained in the hospital longer than 8 days. Length of stay for 67 (97.1%) of 69 patients admitted the day of surgery was from 2 to 3 days; 2 were in the hospital for 7 days, and none for 8 or more days. Thirty-seven instances of surgical complications were reported for the 260 patients admitted the day before surgery (14.2%). Twelve complications (17.4%) were recorded for the 69 patients admitted the day of surgery. There was no significant difference in the number of complications between the two groups of patients (Fisher's exact test, p = 0.5682). There was no significant difference in the types of complications observed between the two groups (Fisher's exact test). Surgery was performed at age 1 year for 61 of the 69 patients admitted on the day of surgery (88.4%). The mean age of this group was significantly younger than that of patients operated on earlier than 1989 and admitted on the day before surgery (Wilcoxon's test, p = .0001, Z = 4.48).(ABSTRACT TRUNCATED AT 250 WORDS)
随着对结果研究的日益关注,持续需要有关当日入院和缩短住院时间是否会对外科治疗产生不利影响的数据,包括唇腭裂手术治疗。在本研究中,检查了1978年至1992年间在该治疗中心接受一期腭裂修复术或唇腭裂修复术的所有1至6岁唇腭裂患者的病历(N = 329)。260名术前一天入院的患者中,251名(96.5%)的住院时间为4至7天;9名住院时间超过8天。69名手术当日入院的患者中,67名(97.1%)的住院时间为2至3天;2名住院7天,无住院8天或更长时间的患者。术前一天入院的260名患者报告了37例手术并发症(14.2%)。手术当日入院的69名患者记录了12例并发症(17.4%)。两组患者的并发症数量无显著差异(Fisher精确检验,p = 0.5682)。两组观察到的并发症类型无显著差异(Fisher精确检验)。69名手术当日入院的患者中,61名(88.4%)在1岁时接受手术。该组的平均年龄明显低于1989年之前手术且术前一天入院的患者(Wilcoxon检验,p = 0.0001,Z = 4.48)。(摘要截断于250字)