Ambulatory chest drainage with advanced nurse practitioner-led follow-up facilitates early discharge after thoracic surgery.
Gen Thorac Cardiovasc Surg
; 71(3): 182-188, 2023 Mar.
Article
in En
| MEDLINE
| ID: mdl-36210394
ABSTRACT
OBJECTIVES:
To demonstrate the safety and feasibility of advanced nurse practitioner-led (ANP-led) outpatient follow-up after discharge with ambulatory chest drains for prolonged air leak and excessive fluid drainage.METHODS:
Patients discharged with ambulatory chest drains between January 2017 and December 2019 were retrospectively reviewed. Discharge criteria included air leak < 200 ml/min or fluid drainage > 100 ml/24 h on a digital drain. Patients were reviewed weekly in the clinic by ANPs, a highly skilled cohort of nurses with physician support available. Outcomes included length of stay, duration of air or fluid leak and complications.RESULTS:
Two-hundred patients were included, amounting to 368 clinic episodes. The median age was 68 ± 13 years and 119 (60%) were male. 112 (56%) patients underwent anatomical lung resection (total anatomical lung resections during the study period = 917) equating to a discharge with ambulatory chest drain rate of 12.2% in this group. The median length of stay was 6 ± 3 days and 176 (88%) patients were discharged with air leak versus 24 (12%) with excessive fluid drainage. The median time to drain removal was 12 ± 11 days. Complications occurred in 16 patients (8%) and 12 (6%) required readmission. An estimated 2075 inpatient days were saved over the study period equating to an annual cost saving of £123,167 (US$149,032) per annum.CONCLUSIONS:
Patients with air leak or excessive fluid drainage can safely be discharged with ambulatory chest drains, allowing them to return to their familiar home environment safely and quickly. ANP-led clinics are a robust and cost-effective follow-up strategy and are associated with a low complication rate.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Discharge
/
Thoracic Surgery
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Gen Thorac Cardiovasc Surg
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
Reino Unido