R E Burney1, K R Jones. 1. Department of Surgery, University of Michigan, TC2922 University Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0331, USA. rburney@umich.edu
Abstract
BACKGROUND: Laparoscopic cholecystectomy is frequently an ambulatory procedure, but some patients are best admitted for a brief hospital stay. In this study, we compared the functional health status, symptoms, and outcomes of patients undergoing ambulatory elective laparoscopic cholecystectomy to those with brief hospital admission. The purpose was to assess patient satisfaction and to identify factors that might assist in selecting patients for ambulatory vs short-stay operations. METHODS: A total of 140 patients scheduled for elective cholecystectomy completed the SF-36 health survey and provided additional information regarding symptoms preoperatively, at 2 months, and at 6 months after operation. RESULTS: All patients had symptomatic gallstones; 76 were admitted to the hospital, and 64 were ambulatory. Admitted patients reported more emotional role limitations on preoperative SF-36. They also reported symptoms of depression more often. Patients in both groups were equally relieved of symptoms of pain, nausea, vomiting, and tenderness. Satisfaction with care was similar for both groups; however, at 2 and 6 months, admitted patients continued to report significantly poorer functional health status than ambulatory patients. CONCLUSION: A reliable, reproducible measure of functional health status, such as the SF-36, may be useful for identifying patients who are appropriate for short-stay hospital admission after laparoscopic cholecystectomy as part of a decision process that tries to optimize outcomes while utilizing resources efficiently.
BACKGROUND: Laparoscopic cholecystectomy is frequently an ambulatory procedure, but some patients are best admitted for a brief hospital stay. In this study, we compared the functional health status, symptoms, and outcomes of patients undergoing ambulatory elective laparoscopic cholecystectomy to those with brief hospital admission. The purpose was to assess patient satisfaction and to identify factors that might assist in selecting patients for ambulatory vs short-stay operations. METHODS: A total of 140 patients scheduled for elective cholecystectomy completed the SF-36 health survey and provided additional information regarding symptoms preoperatively, at 2 months, and at 6 months after operation. RESULTS: All patients had symptomatic gallstones; 76 were admitted to the hospital, and 64 were ambulatory. Admitted patients reported more emotional role limitations on preoperative SF-36. They also reported symptoms of depression more often. Patients in both groups were equally relieved of symptoms of pain, nausea, vomiting, and tenderness. Satisfaction with care was similar for both groups; however, at 2 and 6 months, admitted patients continued to report significantly poorer functional health status than ambulatory patients. CONCLUSION: A reliable, reproducible measure of functional health status, such as the SF-36, may be useful for identifying patients who are appropriate for short-stay hospital admission after laparoscopic cholecystectomy as part of a decision process that tries to optimize outcomes while utilizing resources efficiently.
Authors: R L Kane; N Lurie; C Borbas; N Morris; S Flood; B McLaughlin; G Nemanich; A Schultz Journal: J Am Coll Surg Date: 1995-02 Impact factor: 6.113
Authors: Mark P Lamberts; Marjolein Lugtenberg; Maroeska M Rovers; Anne J Roukema; Joost P H Drenth; Gert P Westert; Cornelis J H M van Laarhoven Journal: Surg Endosc Date: 2012-10-06 Impact factor: 4.584
Authors: Richard A Berger; Sheila A Sanders; Elizabeth S Thill; Scott M Sporer; Craig Della Valle Journal: Clin Orthop Relat Res Date: 2009-02-28 Impact factor: 4.176