Objective To explore the application effect of PDCA cycle management on reducing the unplanned overnight recovery rate in patients undergoing transabdominal preperitoneal inguinal hernia repair (TAPP) under the same-day surgery model. Methods The unplanned overnight recovery rate in patients who underwent TAPP at West China Tianfu Hospital of Sichuan University between January and October 2023 (pre-improvement phase) was analyzed. A quality control group was established, and PDCA cycle management was employed to define control objectives and implement strategies to reduce the unplanned overnight recovery rate. The unplanned overnight recovery rate in patients who underwent TAPP between November 2023 and April 2024 (post-improvement phase) was compared with that in the pre-improvement phase. Results After the implementation of PDCA cycle management, the unplanned overnight recovery rate in patients undergoing TAPP under the same-day surgery reduced from 23.87% (37/155) in the pre-improvement phase to 9.05% (19/210) in the post-improvement phase, with a statistically significant difference (P<0.05). Conclusion The application of PDCA cycle in the process management of TAPP under the same-day surgery model significantly reduces the unplanned overnight recovery rate in patients.
Objective To analyze the epidemic trend of prostate cancer in China from 1992 to 2021, and predict its epidemic trend from 2022 to 2032. Methods Based on the data of Chinese population and prostate cancer incidence and mortality from Global Burden of Disease Database, the Joinpoint log-linear model was used to analyze the trend of prostate cancer incidence and mortality, use the age-period-cohort model to analyze the effects of age, period and cohort on changes in incidence and mortality, and the gray prediction model was used to predict the trend of prostate cancer. Results From 1992 to 2021, the incidence and mortality of prostate cancer in China showed an upward trend, with AAPC of 5.652% (P<0.001) and 3.466% (P<0.001), and the AAPC of age-standardized incidence decreased to 1.990% (P<0.001), the age-standardized mortality showed a downward trend and was not statistically significant. The results of the age-period-cohort model showed that the net drift values of prostate cancer incidence and mortality were 3.03% and -1.06%, respectively, and the risk of incidence and mortality gradually increased with age and period. The results of the grey prediction model showed that the incidence and mortality of prostate cancer showed an upward trend from 2022 to 2032, and the incidence trend was more obvious. Conclusion The incidence and mortality of prostate cancer in China showed an increasing trend, with a heavy disease burden and severe forms of prevention and control, so it is necessary to do a good job in monitoring the incidence and mortality of prostate cancer, and strengthen the efficient screening, early diagnosis and treatment of prostate cancer.
Objective To analyze the causes of unplanned overnight recovery of patients after same-day surgery and put forward countermeasures. Methods The data of same-day surgery patients in the Day Surgery Center of West China Tianfu Hospital of Sichuan University between February 2022 and May 2023 were selected. Patients who recovered overnight were defined as the unplanned overnight recovery group, and patients discharged on the same day after surgery were defined as the normal same-day group. The factors of unplanned overnight recovery after same-day surgery were analyzed. Results A total of 4 259 patients were enrolled, of whom 107 patients had unplanned overnight recovery, 4 152 patients were discharged on the same day after surgery, unplanned overnight recovery group accounted for 2.51% (107/4 259). Except for gender and age (P>0.05), there were significant differences between the two groups in the following six aspects: late starting time of surgery, longer distance from home, medical insurance settlement restrictions, pain, postoperative complications, and patient’s own factors (P<0.05). The results of logistic regression analysis showed that the late starting time of surgery [odds ratio (OR)=9.386, 95% confidence interval (CI) (2.993, 29.432), P<0.001], long distance from address [OR=4.828, 95%CI (2.015, 11.568), P<0.001], medical insurance settlement restrictions [OR=10.667, 95%CI (3.712, 30.658), P<0.001], pain [OR=30.514, 95%CI (7.688, 121.115), P<0.001], postoperative complications [OR=9.642, 95%CI (2.425, 38.342), P=0.001], and patient’s own factors [OR=16.087, 95%CI (10.358, 24.985), P<0.001] were risk factors for unplanned overnight recovery in same-day surgery patients. Conclusions The unplanned overnight recovery of same-day surgery patients in West China Tianfu Hospital of Sichuan University is related to six factors: late starting time of surgery, long distance from home, medical insurance settlement restrictions, pain, postoperative complications, and patient’s own factors. Medical staff can take corresponding measures to reduce the unplanned overnight recovery rate of same-day surgery by strict access standards, optimizing surgical scheduling, formulating individualized enhanced recovery after surgery programs, improving support for patient after discharge, and strengthening perioperative health education.