Evaluation of day surgery <i>versus</i> inpatient surgery for varicose vein in China: a retrospective study based on propensity score matching method_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Mingjun ^1,2 , JIANG Jingwen ³ ,  DAI Yan ¹ , MA Hongsheng ¹ , ZHAO Jichun ⁴

1. Day Surgery Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Nursing in Sichuan University, Chengdu 610041, P. R. China;
3. Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
4. Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

DAI Yan, Email: 1846703501@qq.com

Keywords：

varicose vein; day surgery; inpatient surgery; propensity score matching

DOI：

10.7507/1007-9424.202004106

Video：

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Objective To compare the intraoperative, postoperative indicators and economic costs of varicose veins patients between day surgery and inpatient surgery, and to explore the safety and benefit of large-scale varicose veins day surgery in China.Methods A retrospective study was conducted to collect varicose veins patients in West China Hospital of Sichuan University from January 2016 to January 2019. Patients were divided into the day surgery group and the inpatient surgery group, and the subjects were matched by the propensity score matching (PSM) method according to the basic characteristic data. Intraoperative and postoperative indicators and economic costs were compared between the two groups.Results A total of 1 806 varicose vein patients were enrolled in the study, and 502 patients were enrolled in each of the two groups after PSM matching. After matching, there were no statistically significant differences in gender, age, nationality, marriage status, working status, residence, number of operative legs, medical insurance type, grade of American Society of Anesthesiologists, and complications (including hypertension, diabetes, coronary heart disease, and respiratory system diseases) between the two groups (P>0.05), which were comparable and the differences were not statistically significant. Compared with the inpatient surgery group, the day surgery group had shorter hospital stay, less intraoperative infusion volume, lower total cost, bed cost, nursing cost, drug cost, examination cost, medical insurance, and out-of-pocket (P<0.05). Conclusion The varicose veins day surgery is not only safe and effective, but also can reduce the medication insurance payment.

Citation： HUANG Mingjun, JIANG Jingwen, DAI Yan, MA Hongsheng, ZHAO Jichun. Evaluation of day surgery versus inpatient surgery for varicose vein in China: a retrospective study based on propensity score matching method. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(1): 58-62. doi: 10.7507/1007-9424.202004106 Copy

1.	DePopas E, Brown M. Varicose veins and lower extremity venous insufficiency. Semin Intervent Radiol, 2018, 35(1): 56-61.
2.	Nagpal K, Glore RJ, Chong PL, et al. Day-case re-do varicose vein surgery. Phlebology, 2014, 29(6): 355-357.
3.	Zhang M, Qiu T, Bu X, et al. A national survey on management of varicose veins in China. J Vasc Surg Venous Lymphat Disord, 2018, 6(3): 338-346.
4.	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. Anaesthesia, 2019, 74(6): 778-792.
5.	劉思, 吳洲鵬, 羅艷麗. 開展大隱靜脈曲張剝脫術日間病房運營模式的可行性探討. 中國普外基礎與臨床雜志, 2012, 19(10): 1110-1113.
6.	Hamdan A. Management of varicose veins and venous insufficiency. JAMA, 2012, 308(24): 2612-2621.
7.	吳洲鵬, 趙紀春, 黃斌, 等. 日間單側與雙側大隱靜脈曲張手術并發癥的對比分析. 中國醫師雜志, 2014, 16(7): 868-870.
8.	陸黎, 陸炯, 夏成勇, 等. 大隱靜脈射頻消融術與大隱靜脈高位結扎剝脫術治療靜脈曲張的療效對比. 局解手術學雜志, 2020, 29(1): 38-42.
9.	劉洪, 趙渝. 下肢靜脈曲張微創治療現狀. 中國普外基礎與臨床雜志, 2020, 27(4): 400-403.
10.	官云彪. 下肢靜脈曲張的常用治療方法. 中華普通外科學文獻(電子版), 2020, 14(1): 1-4.
11.	曾彥彰, 楊軼, 趙紀春. 大隱靜脈結扎剝脫聯合泡沫硬化劑與單純泡沫硬化劑治療下肢靜脈性潰瘍的療效比較. 中國普外基礎與臨床雜志, 2018, 25(3): 312-316.
12.	廖懿, 趙紀春. 高位結扎加點式剝脫術治療原發性大隱靜脈曲張的最佳時機. 中國普外基礎與臨床雜志, 2016, 23(2): 198-200.
13.	俞德梁, 劉小南, 寧鵬濤. 中國日間手術政策演變及對醫療決策發展的啟示. 醫學與哲學, 2016, 37(12): 4-7.
14.	孫博, 劉雷, 王東光. 國內日間手術發展進程、存在問題與對策建議. 中國衛生質量管理, 2018, 25(5): 17-20.
15.	Xiong Y, Xu Q, Wang Y, et al. Day surgery is effective and safe for patients with great saphenous vein varices who meet American Society of Anesthesiologists Ⅰ–Ⅱ grading. Niger J Clin Pract, 2016, 19(4): 455-459.
16.	Rivlin E, Haddad M, Landau O, et al. Bilateral versus unilateral high ligation and stripping of the greater saphenous vein for varicose veins. Vasa, 1991, 20(3): 267-269.
17.	Bunnell AP, Zaidi S, Eidson JL 3rd, et al. Factors associated with saphenous vein recanalization after endothermal ablation. Ann Vasc Surg, 2015, 29(2): 322-327.
18.	吉浩, 謝穎夫, 劉靈, 等. 日間手術中心運行對住院醫療費用的影響分析. 中國繼續醫學教育, 2018, 10(29): 72-73.
19.	Walsh MT. Improving outcomes in ambulatory anesthesia by identifying high risk patients. Curr Opin Anaesthesiol, 2018, 31(6): 659-666.
20.	Anwar MA, Lane TR, Davies AH, et al. Complications of radiofrequency ablation of varicose veins. Phlebology, 2012, 27(Suppl 1): 34-39.
21.	Lapage KG, Wouters PF. The patient with hypertension undergoing surgery. Curr Opin Anaesthesiol, 2016, 29(3): 397-402.
22.	Zhuang M, Fan W, Xie P, et al. Evaluation of the safety and quality of day-case cataract surgery based on 4 151 cases. Int J Ophthalmol, 2019, 12(2): 291-295.
23.	Derks LS, Wegner I, Smit AL, et al. Effect of day-case unilateral cochlear implantation in adults on general and disease-specific quality of life, postoperative complications and hearing results, tinnitus, vertigo and cost-effectiveness: protocol for a randomised controlled trial. BMJ Open, 2016, 6(10): e012219.
24.	Kelly MP, Calkins TE, Culvern C, et al. Inpatient versus outpatient hip and knee arthroplasty: which has higher patient satisfaction? J Arthroplasty, 2018, 33(11): 3402-3406.

1. DePopas E, Brown M. Varicose veins and lower extremity venous insufficiency. Semin Intervent Radiol, 2018, 35(1): 56-61.
2. Nagpal K, Glore RJ, Chong PL, et al. Day-case re-do varicose vein surgery. Phlebology, 2014, 29(6): 355-357.
3. Zhang M, Qiu T, Bu X, et al. A national survey on management of varicose veins in China. J Vasc Surg Venous Lymphat Disord, 2018, 6(3): 338-346.
4. 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. Anaesthesia, 2019, 74(6): 778-792.
5. 劉思, 吳洲鵬, 羅艷麗. 開展大隱靜脈曲張剝脫術日間病房運營模式的可行性探討. 中國普外基礎與臨床雜志, 2012, 19(10): 1110-1113.
6. Hamdan A. Management of varicose veins and venous insufficiency. JAMA, 2012, 308(24): 2612-2621.
7. 吳洲鵬, 趙紀春, 黃斌, 等. 日間單側與雙側大隱靜脈曲張手術并發癥的對比分析. 中國醫師雜志, 2014, 16(7): 868-870.
8. 陸黎, 陸炯, 夏成勇, 等. 大隱靜脈射頻消融術與大隱靜脈高位結扎剝脫術治療靜脈曲張的療效對比. 局解手術學雜志, 2020, 29(1): 38-42.
9. 劉洪, 趙渝. 下肢靜脈曲張微創治療現狀. 中國普外基礎與臨床雜志, 2020, 27(4): 400-403.
10. 官云彪. 下肢靜脈曲張的常用治療方法. 中華普通外科學文獻(電子版), 2020, 14(1): 1-4.
11. 曾彥彰, 楊軼, 趙紀春. 大隱靜脈結扎剝脫聯合泡沫硬化劑與單純泡沫硬化劑治療下肢靜脈性潰瘍的療效比較. 中國普外基礎與臨床雜志, 2018, 25(3): 312-316.
12. 廖懿, 趙紀春. 高位結扎加點式剝脫術治療原發性大隱靜脈曲張的最佳時機. 中國普外基礎與臨床雜志, 2016, 23(2): 198-200.
13. 俞德梁, 劉小南, 寧鵬濤. 中國日間手術政策演變及對醫療決策發展的啟示. 醫學與哲學, 2016, 37(12): 4-7.
14. 孫博, 劉雷, 王東光. 國內日間手術發展進程、存在問題與對策建議. 中國衛生質量管理, 2018, 25(5): 17-20.
15. Xiong Y, Xu Q, Wang Y, et al. Day surgery is effective and safe for patients with great saphenous vein varices who meet American Society of Anesthesiologists Ⅰ–Ⅱ grading. Niger J Clin Pract, 2016, 19(4): 455-459.
16. Rivlin E, Haddad M, Landau O, et al. Bilateral versus unilateral high ligation and stripping of the greater saphenous vein for varicose veins. Vasa, 1991, 20(3): 267-269.
17. Bunnell AP, Zaidi S, Eidson JL 3rd, et al. Factors associated with saphenous vein recanalization after endothermal ablation. Ann Vasc Surg, 2015, 29(2): 322-327.
18. 吉浩, 謝穎夫, 劉靈, 等. 日間手術中心運行對住院醫療費用的影響分析. 中國繼續醫學教育, 2018, 10(29): 72-73.
19. Walsh MT. Improving outcomes in ambulatory anesthesia by identifying high risk patients. Curr Opin Anaesthesiol, 2018, 31(6): 659-666.
20. Anwar MA, Lane TR, Davies AH, et al. Complications of radiofrequency ablation of varicose veins. Phlebology, 2012, 27(Suppl 1): 34-39.
21. Lapage KG, Wouters PF. The patient with hypertension undergoing surgery. Curr Opin Anaesthesiol, 2016, 29(3): 397-402.
22. Zhuang M, Fan W, Xie P, et al. Evaluation of the safety and quality of day-case cataract surgery based on 4 151 cases. Int J Ophthalmol, 2019, 12(2): 291-295.
23. Derks LS, Wegner I, Smit AL, et al. Effect of day-case unilateral cochlear implantation in adults on general and disease-specific quality of life, postoperative complications and hearing results, tinnitus, vertigo and cost-effectiveness: protocol for a randomised controlled trial. BMJ Open, 2016, 6(10): e012219.
24. Kelly MP, Calkins TE, Culvern C, et al. Inpatient versus outpatient hip and knee arthroplasty: which has higher patient satisfaction? J Arthroplasty, 2018, 33(11): 3402-3406.

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Evaluation of day surgery versus inpatient surgery for varicose vein in China: a retrospective study based on propensity score matching method

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