1
|
Kelly K, Kolbeinsson H, Blanck LM, Khan M, Kyriakakis R, Assifi MM, Wright GP, Chung M. Can we let our patients sleep in the hospital? A randomized controlled trial of a pragmatic sleep protocol in surgical oncology patients. J Surg Oncol 2024; 129:827-834. [PMID: 38115237 DOI: 10.1002/jso.27565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/07/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Postoperative inpatients experience increased stress due to pain and poor restorative sleep than non-surgical inpatients. OBJECTIVES AND METHODS A total of 101 patients, undergoing major oncologic surgery, were randomized to a postoperative sleep protocol (n = 50) or standard postoperative care (n = 51), between August 2020 and November 2021. The primary endpoint of the study was postoperative sleep time after major oncologic surgery. Sleep time and steps were measured using a Fitbit Charge 4®. RESULTS There was no statistically significant difference found in postoperative sleep time between the sleep protocol and standard group (median sleep time of 427 min vs. 402 min; p = 0.852, respectively). Major complication rates were similar in both groups (7.4% vs. 8.9%). Multivariate analysis found sex and Charlson Comorbidity Index to be significant factors affecting postoperative sleep time and step count. Postoperative delirium was only observed in the standard group, although this did not reach statistical significance. There were no in hospital mortalities. CONCLUSION The use of a sleep protocol was found to be safe in our study population. There was no statistical difference in postoperative sleep time or major complications. Institution of a more humane sleep protocol for postoperative inpatients should be considered.
Collapse
Affiliation(s)
- Kathrine Kelly
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
| | - Hordur Kolbeinsson
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
| | - Lauren M Blanck
- Department of Graduate Medical Education, Michigan State College of Human Medicine, Grand Rapids, Michigan, USA
| | - Mariam Khan
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
| | - Roxanne Kyriakakis
- Division of Colon and Rectal Surgery, Spectrum Health Colon and Rectal Fellowship, Grand Rapids, Michigan, USA
| | - M Mura Assifi
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
- Department of Graduate Medical Education, Michigan State College of Human Medicine, Grand Rapids, Michigan, USA
- Division of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, Michigan, USA
| | - G Paul Wright
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
- Department of Graduate Medical Education, Michigan State College of Human Medicine, Grand Rapids, Michigan, USA
- Division of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, Michigan, USA
| | - Mathew Chung
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
- Department of Graduate Medical Education, Michigan State College of Human Medicine, Grand Rapids, Michigan, USA
- Division of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, Michigan, USA
| |
Collapse
|