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Health and health related outcomes of Chinese adult surgical patients managed by
a nurse-led discharge service: A meta-analysis
#MMPMID41209814
Lin M
; Liu SL
Int J Nurs Stud Adv
2025[Dec]; 9
(?): 100434
PMID41209814
show ga
BACKGROUND: Patients' discharge from the hospital is a major factor for the
continuous normal functioning of the inpatient health care service. A nurse-led
discharge service for surgical patients in China refers to the fact where, with
the advice of the treating doctor, a senior trained nurse takes the main
responsibility to prepare and manage a post-operative patient's discharge from
the hospital, rather than solely depending on the corresponding physician to
handle the discharge process. However, conclusions from individual studies are
often controversial. Meta-analyses provide more precise estimates of the effect
size compared to that of any single study that could have been achieved, reducing
the uncertainty of results thereby generating a more efficient overall estimate
of the effect providing a single, synthesized conclusion with high level evidence
that could be used to develop clinical practice guidelines and inform
decision-making in various fields. Therefore, because of the several positive
aspects of meta-analyses compared to a single individual study, we aimed to
systematically show the health and health related outcomes of Chinese adult
surgical patients managed by a nurse-led discharge service through a
meta-analysis. METHODS: MEDical Literature Analysis and Retrieval System Online,
Web of Science, Excerpta Medica dataBASE, the Cochrane library, Google scholar
and http://www.Clinicaltrials.gov were the search databases. In this
meta-analysis, the statistical work was carried out by the RevMan software
version 5.4. For dichotomous data, risk ratios (RR) with 95% confidence intervals
(CI) were used to represent the results following the meta-analysis. For
continuous data, mean and standard deviation were the inputs, and weighted mean
differences (WMD) with 95% CI were used to represent the results following the
meta-analysis. RESULTS: A total number of 1059 participants were included in this
meta-analysis whereby 504 patients were assigned to the nurse-led discharge group
whereas 555 patients were assigned to the control group. Most of the studies were
randomized trials and participants were enrolled from year 2001 to 2024. All the
participants were of Chinese origin and were from mainland China, Hong Kong or
Taiwan. Results of this meta-analysis showed that this nurse-led discharge
service in Chinese adult surgical inpatients was associated with a significantly
lower risk of re-admission with RR: 0.46, 95% CI: 0.30 - 0.70; P = 0.0003.
However, the risk of mortality was not significantly different (RR: 0.67, 95% CI:
0.31 - 1.44; P = 0.31. Moreover, the mean length of hospital stay with WMD:
[-0.57; 95% CI: (-2.09 - 0.96); P = 0.47] and quality of life with WMD [5.48, 95%
CI: (-1.92 - 12.88); P = 0.15] were similarly manifested. CONCLUSIONS: Based on
the results of this meta-analysis, a nurse-led discharge service in Chinese adult
surgical inpatients is effective in terms of reducing the risk of re-admission to
the hospital. However, no significant difference has been observed in terms of
improving mortality risk, the length of hospital stay and the quality of life.
Even though our meta-analysis could clarify inconsistent finding from individual
studies, providing a single, synthesized conclusion, with higher level evidence,
newer larger studies would be required to confirm whether a nurse-led discharge
service would really be effective in China due to limited data.
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