Objective To analyze the risk factors of delayed discharge among lung cancer patients undergoing day surgery to provide reference for reducing the delayed discharge of patients. Methods The data of lung cancer patients who accepted the day surgery were retrospectively collected during April 1st 2020 to November 30th 2021. The patients were divided into two groups,normal discharge group（stayed less than 48 h） and delayed discharge group（stayed over 48 h）. Univariate analysis and logistic regression were used to analyze the risk factor of delayed discharge. Results 1 363 patients were collected,223 patients were delayed and the incidence of delayed discharge was 16.4%. Univariate analysis showed that age,the local resident,the surgery type,surgery length,amount of bleeding,nausea and vomiting,anticoagulant therapy,mechanical prophylaxis were different between delayed discharge patients and normal discharge patients（P<0.05）. Logistic regression showed that age[OR=1.020,95%CI（1.007,1.036）],surgery length[OR=1.014,95%CI（1.010,1.017）],nausea and vomiting[OR=1.567,95%CI（1.052,2.332）] were independent risk factors（P<0.05）. Anticoagulant therapy[OR=0.113,95%CI（0.081,0.158）],mechanical prophylaxis[OR=0.504,95%CI（0.270,0.943）] were protective factors（P<0.05）. Conclusion It suggests that nurses need to focus on these risk factors for lung cancer patients who undergo day surgery,enhance their risk assessment and education during perioperative period,actively understand their intraoperative situation,and give an early individual intervention to reduce their risk of delayed discharge.
[1] Nasim F,Sabath BF,Eapen GA.Lung cancer[J]. Med Clin North Am,2019,103(3):463-473.
[2] Aytekin İ,Şanli M,Işik AF,et al. Outcomes after lobectomy and pneumonectomy in lungcancer patients aged 70 years or older[J]. Turk J Med Sci,2017,47(1):307-312.
[3] 车国卫. 加速康复外科:肺癌手术日间化现状与策略[J]. 中国肺癌杂志,2020,23(1):1-4.
Che GW.Current situation and strategy of day surgery in patients with lung cancer by enhanced recovery after surgery[J]. Chin J Lung Cancer,2020,23(1):1-4.
[4] 国际日间手术学会[编著],中国日间手术合作联盟[主译]国际日间手术学会[编著],中国日间手术合作联盟[主译]. 日间手术手册[M]. 北京:人民卫生出版社,2015.
International Society of Daytime Surgery[Compile],China Daytime Surgery Cooperation Alliance[Main translator]International Society of Daytime Surgery[Compile],China Daytime Surgery Cooperation Alliance[Main translator]. Ambulatory surgery handbook[M]. Beijing:People's Medical Publishing House,2015.
[5] 王建芦,赵汝楠,郭晓宇,等. 肝胆外科日间手术管理流程优化的应用效果分析[J]. 齐鲁护理杂志,2020,26(16):32-35.
Wang JL,Zhao RN,Guo XY,et al.Application effect analysis of day surgery management process optimization in hepatobiliary surgery[J]. J Qilu Nurs,2020,26(16):32-35.
[6] 梁宇,侯和磊,姜曼,等. 中国年轻肺腺癌患者基因特点研究[J]. 中国肺癌杂志,2020,23(4):239-246.
Liang Y,Hou HL,Jiang M,et al.Genetic profile of young Chinese patients with lung adenocarcinoma[J]. Chin J Lung Cancer,2020,23(4):239-246.
[7] Jean RA,Chiu AS,Boffa DJ,et al.Delayed discharge does not decrease the cost of readmission after pulmonary lobectomy[J]. Surgery,2018,164(6):1294-1299.
[8] 刘洋,李志超,马洪升. 四川大学华西医院日间手术患者延迟出院原因分析[J]. 中国循证医学杂志,2016,16(4):383-386.
Liu Y,Li ZC,Ma HS.Analysis of the causes of delay discharge patients at day surgery in West China Hospital of Sichuan University[J]. Chin J Evid Based Med,2016,16(4):383-386.
[9] Bailey CR,Ahuja M,Bartholomew K,et al.Guidelines for day-case surgery 2019:guidelines from the Association of Anaesthetists and the British Association of Day Surgery[J]. Anaesthesia,2019,74(6):778-792.
[10] 孙翔翔,徐美青. 胸腔镜下三种手术方式治疗早期肺癌的疗效及对肺功能的影响研究[J]. 湖南师范大学学报(医学版),2021,18(1):68-71.
Sun XX,Xu MQ.Curative efficacy of three types of thoracoscopic surgery in treatment of early lung cancer and its effectson lung function[J]. J Hunan Norm Univ Med Sci,2021,18(1):68-71.
[11] Gulley JL,Rajan A,Spigel DR,et al.Avelumab for patients with previously treated metastatic or recurrent non-small-cell lung cancer(JAVELIN Solid Tumor):dose-expansion cohort of a multicentre,open-label,phase 1b trial[J]. Lancet Oncol,2017,18(5):599-610.
[12] 夏俊伟,吴茜,张霜,等. 全髋关节置换术患者延迟出院的危险因素分析[J]. 临床麻醉学杂志,2020,36(4):354-358.
Xia JW,Wu X,Zhang S,et al.Risk factors for delayed hospital discharge in patients undergoing total hip joint replacement surgery[J]. J Clin Anesthesiol,2020,36(4):354-358.
[13] 俞德梁,刘小南,高博欣,等. 食管裂孔疝手术后24小时内出院影响因素分析及预测模型构建[J]. 临床外科杂志,2021,29(10):941-944.
Yu DL,Liu XN,Gao BX,et al.Analysis of independent factors and construction of predictive model of discharge within 24 hours after operation of hiatal hernia[J]. J Clin Surg,2021,29(10):941-944.
[14] 蒋丽莎,詹丽莉,沈诚,等. 日间手术模式下胸腔镜手术治疗肺结节的安全性分析[J]. 华西医学,2020,35(2):152-155.
Jiang LS,Zhan LL,Shen C,et al.Safety analysis of day surgery program of video-assisted thoracoscopic surgery for pulmonary nodule[J]. West China Med J,2020,35(2):152-155.
[15] Rae A.Reasons for delayed patient discharge following day surgery:a literature review[J]. Nurs Stand,2016,31(11):42-51.
[16] 周海英,张玉侠,陈潇,等. 肝癌患者术后恶心呕吐发生现况及影响因素研究[J]. 中华护理杂志,2022,57(2):182-187.
Zhou HY,Zhang YX,Chen X,et al.The incidence and risk factors of postoperative nausea and vomiting in liver cancer[J]. Chin J Nurs,2022,57(2):182-187.
[17] López JLT,Cadahía DP,Noalles MJA,et al.Perioperative factors that contribute to postoperative pain and/or nausea and vomiting in ambulatory laparoscopic surgery[J]. Rev Esp Anestesiol Reanim(Engl Ed),2019,66(4):189-198.
[18] Weitz JI,Haas S,Ageno W,et al.Cancer associated thrombosis in everyday practice:perspectives from GARFIELD-VTE[J]. J Thromb Thrombolysis,2020,50(2):267-277.
[19] Japanese Circulation Society.Guidelines for the diagnosis,treatment and prevention of pulmonary thromboembolism and deep vein thrombosis(JCS 2004)[J]. J Cardiol,2005,45(3):349-366.
[20] 王岚,沈文军. 胸腔镜肺癌切除术后患者静脉血栓栓塞症的预防性护理[J]. 护理学杂志,2020,35(14):13-15.
Wang L,Shen WJ.Preventive nursing intervention for pulmonary embolism after thoracoscopic resection of lung cancer[J]. J Nurs Sci,2020,35(14):13-15.
