Fast-track concepts in routine pediatric surgery: a prospective study in 436 infants and children |
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Authors: | Marc Reismann Jens Dingemann Mathias Wolters Birgit Laupichler Robert Suempelmann Benno M Ure |
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Institution: | (1) Department of Pediatric Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany;(2) Department of Anesthesiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany |
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Abstract: | Background and aims The aim of this study was to investigate fast-track concepts in routine pediatric surgery in a university clinic over 1 year.
Patients/methods Fast-track concepts were established for procedures requiring hospital admission in patients up to 15 years of age. Patients
were studied prospectively from June 2006 to June 2007.
Results Out of a total of 436 potentially suitable patients, 155 (36%) were finally treated following the protocols. The mean intensity
of pain in children younger than 4 years (CHIPPS, 0–10) was 1.3 ± 1.5 the evening of the operation day and decreased to <1
at all other time points. The initial postoperative mean pain intensity in older children (Smiley/VAS, 1–10) was 3.7 ± 2.2
and decreased constantly thereafter. The mean hospital stay of fast-track patients was significantly shorter compared with
German diagnosis-related group data (4.6 ± 2.9 versus 9.7 ± 3.8, p < 0.01). There were four (3%) readmissions for minor complications. At follow-up after 2 weeks, 95% of patients and parents
judged fast-track care as excellent.
Conclusion Fast-track concepts are feasible in one third of pediatric patients undergoing routine in-hospital surgery. Fast-track pediatric
surgery achieves accelerated convalescence, minimal hospital stay, and high patient and parent satisfaction. |
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Keywords: | Fast-track surgery Children |
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