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.
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Sortie hôpital, Précoce, Chirurgie, Etude en condition contrôlée, Evaluation, Morbidité, Effet psychologique, Homme, Femelle, Randomisation, Glande mammaire pathologie
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Hospital discharge, Early, Surgery, Controlled environment study, Evaluation, Morbidity, Psychological effect, Human, Female, Randomization, Mammary gland diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0000665
Code Inist : 002B20E02. Création : 31/05/1999.