Clinical trial NCT04142203: Implementation of 23 Hour Surgery Model in a Tertiary Hospital
Official title: 23 Hour Surgical Model in a Tertiary Hospital: Evaluation From Patient and Organisational Perspective
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Ambulatory Surgery
Laparoscopy
Shoulder Impingement Syndrome
Ovarian Cysts
Cholecystolithiasis
Appendicitis
Gynecologic Surgical Procedures
Ambulatory Surgical Procedures
Neurosurgery
Keywords: 23 h surgery
postoperative recovery
outcome
patient satisfaction
postoperative pain
analgesic
oxycodone
multimodal pain management
extended day surgery
Lead sponsor: Kuopio University Hospital
Sponsor class: OTHER
First posted: 2019-10-29
Enrollment: 993
Sex: ALL
Minimum age (years): 18
Maximum age (years): 100
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Adults undergoing 23 h surgery

Brief summary: Extended day surgery or 23 h surgery (23-hour surgery) is a surgical model where patients arrive to the hospital from home at the day of surgery, are operated and recover in a 23 h surgery unit. 23H surgery units are usually situated near postoperative recovery unit. THe 23 H surgical model was implemented in Kuopio University Hospital 2015 and between May 2017-May 2018 patients were recruited in the present prospective follow up cohort study. Patients were informed and they gave their informed consent. The patients were contacted two weeks after the study and details of their recovery were asked.

Detailed description: Extended day surgery or 23 h surgery is a surgical model where patients arrive to the hospital from home at the day of surgery, are operated and recover in a 23 h surgery unit. 23H surgery units are usually situated near postoperative recovery unit. THe 23 H surgical model was implemented in Kuopio University Hospital 2015 and between May 2017-May 2018 patients were recruited in the present prospective follow up cohort study. Patients were informed and they gave their informed consent. The patients were contacted two weeks after the study and details of their recovery were asked. Satisfaction to the care in 23 h unit and surgical process, were asked. Amount of readmissions, reoperations, contacts to health care professionals and adverse events are recorded.

Detailed information about intensity of pain, analgesic need and use in the hospital was recorded and pain interference in daily life for short term recovery period was asked.

Eligibility criteria: Inclusion Criteria:

* adult
* gave informed consent

Exclusion Criteria:

* no informed consent

Primary outcomes:
measure: Amount of patients discharged from the hospital until 10 am at the first postoperative day
timeFrame: Postoperative day 1
measure: Pain intensity postoperatively
timeFrame: Postoperative day 1
measure: Analgesic consumption postoperatively
timeFrame: Postoperative day 1
Secondary outcomes:
measure: 30 days readmission rate
timeFrame: one month after surgery
measure: 30 days reoperation rate
timeFrame: one month after surgery
measure: Number of adverse events during 14 postoperative days
timeFrame: 14 days after surgery
measure: Contact to health care during 14 postoperative days
timeFrame: 14 days afte surgery
measure: Patient satisfaction to care in 23 hours process
timeFrame: 14 days after surgery
measure: Proportion of patients having pain postoperatively
timeFrame: Two weeks postoperatively
measure: Postoperative pain interference after 23 h surgery
timeFrame: two weeks postoperatively
measure: Analgesic use after 23 h surgery
timeFrame: Two weeks postoperatively
Other outcomes:
measure: Adverse events after 23 h surgery
timeFrame: two weeks after surgery
Locations:
city: Kuopio
country: Finland
facility: Kuopio University Hospital
state: Northern Savo
Study officials:
affiliation: Kuopio University Hospital
name: Ulla-Maija Ruohoaho, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Isokaanta S, Ruohoaho UM, Anttila M, Kokki H, Sintonen H, Toroi P, Kokki M. Resilience, pain, and health-related quality of life in gynecological patients undergoing surgery for benign and malignant conditions: a 12-month follow-up study. BMC Womens Health. 2022 Aug 16;22(1):345. doi: 10.1186/s12905-022-01923-7.
citation: Ruohoaho UM, Aaltomaa S, Kokki H, Anttila M, Kokki M. Patient functional recovery after a 23-h surgery - a prospective, follow-up study. Langenbecks Arch Surg. 2022 Aug;407(5):2133-2142. doi: 10.1007/s00423-022-02502-y. Epub 2022 Apr 6.
citation: Ruohoaho UM, Toroi P, Hirvonen J, Aaltomaa S, Kokki H, Kokki M. Implementation of a 23-h surgery model in a tertiary care hospital: a safe and feasible model with high patient satisfaction. BJS Open. 2020 Jun;4(3):391-399. doi: 10.1002/bjs5.50267. Epub 2020 Feb 28.