Return to home early days after acute aortic dissection surgery.
OBJECTIVE
The length of hospital stay after acute aortic dissection surgery tends to be prolonged. The aim of this study is to assess the feasibility of our protocol for early discharge after acute aortic dissection surgery.


METHODS
This study enrolled 17 consecutive acute aortic dissection patients who returned to their own home within 2 weeks of surgery. In seven patients total aortic arch replacement was performed and in 7 partial arch replacement. The main aim of the first 24 h after surgery was to achieve early extubation. Patients were encouraged to return to their own home 4 days and later after surgery. The prerequisite criteria for discharge were the following: independent mobility, stable hemodynamics, apyrexia, adequate oral intake, normal bowel function, healthy surgical wound and the patient's agreement for discharge.


RESULTS
The mean age of these patients was 59. The postoperative ventilation time, length of intensive care unit stay and postoperative hospital stay were 11 h, 37 h and 6.9 days, respectively. Two (12%), 13 (76%) and 14 (82%) patients returned to their own home by postoperative day 4, 7 and 10, respectively. Three patients were readmitted to a peripheral hospital in the 4 week postoperative period. The reason for all readmissions was lack of family support. Two other patients underwent pericardiocentesis for pericardial effusion at an other hospital as outpatients. There was no complication caused by early discharge.


CONCLUSIONS
Early discharge after aortic dissection surgery is safe and recommended to patients who have normal bowel function and adequate family support.
Fujii
H
H
Department of Emergency and Critical Care Medicine, Kansai Medical University, Moriguchi, Osaka, Japan. fujiih@takii.kmu.ac.jp
Kitazawa
Y
Y
Saito
F
F
Tsuda
M
M
Yabuki
T
T
Kajimoto
S
S
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D002985:Clinical Protocols; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission; D013997:Time Factors