Randomised controlled trial of effects of early discharge after surgery for breast cancer.

2.50
Hdl Handle:
http://hdl.handle.net/10541/91971
Title:
Randomised controlled trial of effects of early discharge after surgery for breast cancer.
Authors:
Bundred, Nigel J; Maguire, Peter; Reynolds, Jill; Grimshaw, Jill; Morris, Julie; Thomson, Lesley; Barr, Lester; Baildam, Andrew D
Abstract:
OBJECTIVE: To determine the effect of early discharge from hospital after surgery for breast cancer on physical and psychological illness. DESIGN: Randomised controlled trial comparing discharge two days after surgery (before removal of drain) with standard management (discharge after removal of drain). SETTING: Regional breast unit. SUBJECTS: 100 women with early breast cancer undergoing mastectomy and axillary node clearance (20) or breast conservation surgery (80). MAIN OUTCOME MEASURES: Physical illness (infection, seroma formation, shoulder movement) and psychological illness (checklist of concerns, Rotterdam symptom questionnaire, hospital anxiety and depression scale) preoperatively and at one month and three months postoperatively. RESULTS: Women discharged early had greater shoulder movement (odds ratio 0.28 (95% confidence interval 0.08 to 0.95); P = 0.042) and less wound pain (odds ratio 0.28 (0.10 to 0.79); P = 0.016) three months after surgery compared with women given standard management. One month after surgery scores were significantly lower on the Rotterdam symptom questionnaire in patients who were discharged early (ratio of geometric mean scores 0.73 (0.55 to 0.98) P = 0.035), but rates of psychological illness generally did not differ between groups. CONCLUSIONS: Increased rates of physical or psychological illness did not result from early discharge after surgery for breast cancer. This policy can be recommended for patients with support at home.
Affiliation:
Department of Surgery, Christie Hospital NHS Trust, Manchester M20 4BX. bundredn@fs1.with.man.ac.uk
Citation:
Randomised controlled trial of effects of early discharge after surgery for breast cancer. 1998, 317 (7168):1275-9 BMJ
Journal:
BMJ
Issue Date:
7-Nov-1998
URI:
http://hdl.handle.net/10541/91971
PubMed ID:
9804712
Type:
Article
Language:
en
ISSN:
0959-8138
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorBundred, Nigel Jen
dc.contributor.authorMaguire, Peteren
dc.contributor.authorReynolds, Jillen
dc.contributor.authorGrimshaw, Jillen
dc.contributor.authorMorris, Julieen
dc.contributor.authorThomson, Lesleyen
dc.contributor.authorBarr, Lesteren
dc.contributor.authorBaildam, Andrew Den
dc.date.accessioned2010-02-12T12:20:17Z-
dc.date.available2010-02-12T12:20:17Z-
dc.date.issued1998-11-07-
dc.identifier.citationRandomised controlled trial of effects of early discharge after surgery for breast cancer. 1998, 317 (7168):1275-9 BMJen
dc.identifier.issn0959-8138-
dc.identifier.pmid9804712-
dc.identifier.urihttp://hdl.handle.net/10541/91971-
dc.description.abstractOBJECTIVE: To determine the effect of early discharge from hospital after surgery for breast cancer on physical and psychological illness. DESIGN: Randomised controlled trial comparing discharge two days after surgery (before removal of drain) with standard management (discharge after removal of drain). SETTING: Regional breast unit. SUBJECTS: 100 women with early breast cancer undergoing mastectomy and axillary node clearance (20) or breast conservation surgery (80). MAIN OUTCOME MEASURES: Physical illness (infection, seroma formation, shoulder movement) and psychological illness (checklist of concerns, Rotterdam symptom questionnaire, hospital anxiety and depression scale) preoperatively and at one month and three months postoperatively. RESULTS: Women discharged early had greater shoulder movement (odds ratio 0.28 (95% confidence interval 0.08 to 0.95); P = 0.042) and less wound pain (odds ratio 0.28 (0.10 to 0.79); P = 0.016) three months after surgery compared with women given standard management. One month after surgery scores were significantly lower on the Rotterdam symptom questionnaire in patients who were discharged early (ratio of geometric mean scores 0.73 (0.55 to 0.98) P = 0.035), but rates of psychological illness generally did not differ between groups. CONCLUSIONS: Increased rates of physical or psychological illness did not result from early discharge after surgery for breast cancer. This policy can be recommended for patients with support at home.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAnxiety-
dc.subject.meshBreast Neoplasms-
dc.subject.meshDepression-
dc.subject.meshDrainage-
dc.subject.meshEdema-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInfection-
dc.subject.meshLength of Stay-
dc.subject.meshLymph Node Excision-
dc.subject.meshMastectomy-
dc.subject.meshMiddle Aged-
dc.subject.meshMusculoskeletal Diseases-
dc.subject.meshPrognosis-
dc.subject.meshShoulder Joint-
dc.titleRandomised controlled trial of effects of early discharge after surgery for breast cancer.en
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery, Christie Hospital NHS Trust, Manchester M20 4BX. bundredn@fs1.with.man.ac.uken
dc.identifier.journalBMJen

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