To analyze the consequences and predisposing factors associated with patient self-discharge against medical advice in plastic, aesthetic, hand, and reconstructive surgery, emphasizing the impact on patient outcomes.
Key Findings:
Self-discharge rate increased from 2.6% to 4.7% over 10 years, indicating a concerning trend.
Patients who self-discharged were more likely to live in shared households and have children, suggesting socio-demographic factors at play.
Self-discharged patients reported a higher complication rate (19.2%) compared to the control group (10.0%), underscoring the risks involved.
Revision operation rate was significantly higher in self-discharged patients (17.8% vs. 3.1%), indicating potential long-term consequences.
Self-discharged patients had lower pain scores at discharge compared to the control group, which may influence their decision to leave.
Interpretation:
Self-discharge against medical advice is associated with higher complication rates and reoperation, despite relatively high patient satisfaction, indicating a need for further research and targeted interventions.
Limitations:
Single-center study may limit generalizability and introduce bias.
Follow-up data was only available for a subset of self-discharged patients, potentially skewing results.
Conclusion:
Self-discharge is increasing in plastic and hand surgery, with significant predictors identified. Higher complication and reoperation rates suggest the need for improved patient education and support strategies.
by Sören Könneker, Rosalia Luketina, Stefaniya Bozadzhieva, Thomas von Lengerke, Nicco Krezdorn, Theodore L. H. Luketina, Peter M. Vogt, Alexander Kaltenborn
