Urologic oncology · 2025
Protocol-driven same day discharge for robotic radical prostatectomy.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Roebuck Emily H, McGrath Lila G, Robinson Myra, Whitton Katherine, Matulay Justin T, Clark Peter E, Riggs Stephen B
Аннотация
PURPOSE: Average length of stay following robot-assisted laparoscopic prostatectomy (RALP) ranges from 24 to 48 hours. This study evaluates the implementation, safety, and efficacy of a standardized same-day discharge (SDD) protocol for RALP patients compared to inpatient stay.
MATERIALS AND METHODS: We conducted a retrospective cohort study of 220 patients who underwent RALP at a single academic center from January 2022 to September 2023. We implemented a standardized SDD protocol on August 1, 2022, expanding eligibility criteria and formalizing perioperative management. Patients were categorized into same-day discharge (SDD) or inpatient (IP-RALP) groups for analysis. Categorical endpoints were compared between cohorts with Fisher's exact tests while continuous outcomes were compared with Wilcoxon rank sum tests.
RESULTS: 220 males underwent RALP, with 132 (88.6%) of 149 SDD-initiated patients successfully discharged on the same day. Outcomes including ED visits, 30-day readmission rates, were similar between groups, with no significant differences observed in 24-hour readmissions (SDD 0.8%, IP-RALP 0%, P > 0.99). While 30-day readmissions were slightly higher in SDD (9.1% vs. 4.6%), this was not statistically significant (P = 0.29). Complication rates and number of follow-up calls were similar across cohorts. Formal SDD protocol implementation improved POD1 contact rates (48% vs. 73.8%, P = 0.01) and consistency in discharge medication management.
CONCLUSIONS: Our findings suggest SDD after prostatectomy is safe, with no observed increased risk of ED visits, readmissions, or complications compared to IP-RALP. Formal SDD protocol implementation improved consistency in discharge processes. Future studies are needed to further elucidate preoperative risk stratification for appropriate tailoring of protocol driven care.
MATERIALS AND METHODS: We conducted a retrospective cohort study of 220 patients who underwent RALP at a single academic center from January 2022 to September 2023. We implemented a standardized SDD protocol on August 1, 2022, expanding eligibility criteria and formalizing perioperative management. Patients were categorized into same-day discharge (SDD) or inpatient (IP-RALP) groups for analysis. Categorical endpoints were compared between cohorts with Fisher's exact tests while continuous outcomes were compared with Wilcoxon rank sum tests.
RESULTS: 220 males underwent RALP, with 132 (88.6%) of 149 SDD-initiated patients successfully discharged on the same day. Outcomes including ED visits, 30-day readmission rates, were similar between groups, with no significant differences observed in 24-hour readmissions (SDD 0.8%, IP-RALP 0%, P > 0.99). While 30-day readmissions were slightly higher in SDD (9.1% vs. 4.6%), this was not statistically significant (P = 0.29). Complication rates and number of follow-up calls were similar across cohorts. Formal SDD protocol implementation improved POD1 contact rates (48% vs. 73.8%, P = 0.01) and consistency in discharge medication management.
CONCLUSIONS: Our findings suggest SDD after prostatectomy is safe, with no observed increased risk of ED visits, readmissions, or complications compared to IP-RALP. Formal SDD protocol implementation improved consistency in discharge processes. Future studies are needed to further elucidate preoperative risk stratification for appropriate tailoring of protocol driven care.