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Titolo:
Outpatient tympanomastoidectomy - Factors affecting hospital admission
Autore:
Megerian, CA; Reily, J; OConnell, FM; Heard, SO;
Indirizzi:
Univ Massachusetts, Sch Med, Dept Otolaryngol Head & Neck Surg, Worcester,MA 01655 USA Univ Massachusetts Worcester MA USA 01655 ck Surg, Worcester,MA 01655 USA Univ Massachusetts, Med Ctr, Dept Anesthesiol, Worcester, MA 01655 USA Univ Massachusetts Worcester MA USA 01655 hesiol, Worcester, MA 01655 USA Univ Massachusetts, Med Ctr, Dept Surg, Worcester, MA 01655 USA Univ Massachusetts Worcester MA USA 01655 t Surg, Worcester, MA 01655 USA Univ Massachusetts, Med Ctr, Dept Otolaryngol Head & Neck Surg, Worcester,MA 01655 USA Univ Massachusetts Worcester MA USA 01655 ck Surg, Worcester,MA 01655 USA Albert Einstein Coll Med, New York, NY USA Albert Einstein Coll Med New York NY USA tein Coll Med, New York, NY USA
Titolo Testata:
ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY
fascicolo: 11, volume: 126, anno: 2000,
pagine: 1345 - 1348
SICI:
0886-4470(200011)126:11<1345:OT-FAH>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
MIDDLE-EAR SURGERY; PROPHYLACTIC ANTIEMETIC THERAPY; ANESTHETIC TECHNIQUES; GENERAL-ANESTHESIA; NAUSEA; GRANISETRON; PREVENTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
14
Recensione:
Indirizzi per estratti:
Indirizzo: Megerian, CA Univ Massachusetts, Sch Med, Dept Otolaryngol Head & Neck Surg, 55 Lake Ave N, Worcester, MA 01655 USA Univ Massachusetts 55 Lake Ave N Worcester MA USA 01655 5 USA
Citazione:
C.A. Megerian et al., "Outpatient tympanomastoidectomy - Factors affecting hospital admission", ARCH OTOLAR, 126(11), 2000, pp. 1345-1348

Abstract

Background: Outpatient tympanomastoidectomy is common in many medical centers. However, failure of same-day discharge is often the result of postoperative nausea and vomiting (PONV). Many times this leads to hospital admission after tympanomastoidectomy, and it is often difficult to predict before surgery whether PONV will be an issue that impedes same-day discharge. Objective: To determine the clinical factors correlated with the incidenceof PONV requiring hospital admission after chronic ear surgery by hypothesizing that the complexity of a particular case, as measured using a 10-point scale, is predictive of surgical time or failure of same-day hospital discharge. Study Design: Retrospective medical chart review of 103 patients having mastoidectomy with tympanoplasty for chronic otitis media over a 2-year period. Methods: We recorded patient age, clinical data, surgical times, types of agents used for induction and maintenance of anesthesia, use of prophylactic antiemetic drugs, types and doses of analgesic agents, and PONV. Univariate and multivariate logistic regression analyses were performed to determine which variables were associated with PONV that required hospital admission. Results: One third of patients studied were safely discharged from the hospital the day of surgery, and 92% were discharged within 23 hours. The mostcommon cause for observation admission to the hospital was PONV. The only variable in multivariate analysis that significantly correlated with PONV mandating hospital admission after tympanomastoid surgery was a history of motion sickness or PONV (odds ratio, 5.21; P=.02). Although severity of disease did not correlate with length of hospital stay, it directly correlated with length of surgery. Conclusions: A history of PONV or motion sickness is predictive of PONV and length of hospital stay. Routine planning for a 23-hour overnight observation stay seems warranted for all patients undergoing tympanomastoidectomy,despite severity of disease.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/09/20 alle ore 23:28:47