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dc.contributor.authorBundred, Nigel J
dc.contributor.authorMaguire, Peter
dc.contributor.authorReynolds, Jill
dc.contributor.authorGrimshaw, Jill
dc.contributor.authorMorris, Julie
dc.contributor.authorThomson, Lesley
dc.contributor.authorBarr, Lester
dc.contributor.authorBaildam, Andrew D
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.
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
html.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.


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