Discharge Criteria and Complications After Ambulatory Surgery

Marshall, Scott; Chung, Frances

doi:10.1097/00000539-199903000-00008

Cited by 126 publications

(55 citation statements)

References 78 publications

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“…Post-operative pain is the most commonly reported complication of day care anaesthesia with up to 50% of patients experiencing wound pain. [13] However, this study did not show that instead it demonstrated that the use of opiates can lead to PONV requiring admission.…”

Section: Discussionmentioning

confidence: 62%

A nested case-control study to determine the incidence and factors associated with unanticipated admissions following day care surgery

Singh¹,

Ponniah²,

Jacob³

2016

Indian J Anaesth

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Background and Aims:Day care surgery offers respite from hospitalisation for specific surgical procedures and has many advantages. However, occasionally patients who undergo such surgery require hospitalisation for unanticipated complications. We aimed to determine their incidence and to identify factors associated with unanticipated admissions in a tertiary care hospital in South India.Methods:During the 3-month study, 63 cases requiring admission and 126 randomly selected controls were taken from the 776 procedures that were performed were compared. The variables studied were patients’ demographic characteristics, pre-operative medical illness, personal habits, American Society of Anesthesiologists status, the diagnosis and surgical procedures, time since last meal, duration of anaesthesia and surgery, experience of the surgeon and anaesthetist, and intraoperative management (techniques, drugs, monitoring, etc.). Univariate and bivariate statistics were used to determine factors associated with unanticipated admissions.Results:The incidence of unanticipated admissions following day care surgery was 8.11%. The reasons for admission were anaesthetic (33.33%), surgical (15.87%), medical (6.34%) and social (44.44%). The factors significantly associated with unanticipated admissions included duration of anaesthesia more than 50 min (odds ratio [OR]: 3.179; 95% confidence interval [CI]: 1.503–6.722), and starting the last case after 3 pm (OR: 10.095; 95% CI: 2.418–42.148).Conclusion:Unanticipated admissions following day care surgery occur mainly due to anaesthetic, surgical, medical and social reasons.

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Section: Discussionmentioning

confidence: 62%

A nested case-control study to determine the incidence and factors associated with unanticipated admissions following day care surgery

Singh¹,

Ponniah²,

Jacob³

2016

Indian J Anaesth

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“…This kind of collaboration between public and private hospitals has not been analyzed and reported in the literature, while collaboration between university and county hospitals has already been published, but was on a different basis [9,10,11,12]. …”

Section: Discussionmentioning

confidence: 99%

“…The procedure was carried out by the public hospital senior surgeon and one of the residents as an assistant. After the procedure, the patient was observed in the recovery room and returned home the same day if standardized discharge criteria were fulfilled [9,10]. These are essentially the acronym AAAAM (awake, analgesia, ambulating, alimentation and miction).…”

Section: Methodsmentioning

confidence: 99%

Cost-Effective Utilization of a Private Facility to Perform Outpatient Surgery in Public Hospital Waiting List Patients

Vuilleumier¹,

Coquelin²,

Wasserfallen

et al. 2011

Dig Surg

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Background: Public hospitals’ long waiting lists make outpatient surgery in private facilities very attractive provided a standardized protocol is applied. The aim of this study was to assess this kind of innovative collaboration in abdominal surgery from a clinical and economical perspective. Methods: All consecutive patients operated on in an outpatient basis in a private facility by a public hospital abdominal surgeon and an assistant over a 5-year period (2004–2009) were included. Clinical assessment was carried out from patients’ charts and satisfaction questionnaire, and economic assessment from the comparison between the surgeons’ charges paid by the private facility and the surgeons’ hospital salaries during the days devoted to surgery at the private facility. Results: Over the 5 years, 602 operative procedures were carried out during 190 operative days. All patients could be discharged the same day and only 1% of minor complications occurred. The patients’ satisfaction was 98%. The balance between the surgeons’ charges paid by the private facility and their hospital salary costs was positive by 25.8% for the senior surgeon and 12.6% for the assistant or, on average, 21.9% for both. Conclusion: Collaboration between an overloaded university hospital surgery department and a private surgical facility was successful, effective, safe, and cost-effective. It could be extended to other surgical specialities.

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“…PADSS considers five criteria: vital signs, ambulation, nausea/vomiting, pain, and bleeding. Requirements to drink and void have been removed from newer version of PADSS [32].…”

Section: Nonmedical Criteria Are As Followsmentioning

confidence: 99%

Hernia in Ambulatory Surgery Centre

Šeparović¹,

Augustin²

2017

Hernia

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Surgical treatment of hernia is one of the most common procedures in general population. Since it was traditionally treated as "non-complex" operation, it is an ideal procedure for ambulatory surgery settings. Ambulatory surgery is superior to in-hospital treatment due to faster patient flow, reduced patient stress, early mobilization, and lower overall costs. Unforeseen hospitalization can be avoided with meticulous patient selection, education and preparation, use of local anesthesia whenever possible, and avoidance of opioids in early postoperative period.

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Discharge Criteria and Complications After Ambulatory Surgery

Cited by 126 publications

References 78 publications

A nested case-control study to determine the incidence and factors associated with unanticipated admissions following day care surgery

A nested case-control study to determine the incidence and factors associated with unanticipated admissions following day care surgery

Cost-Effective Utilization of a Private Facility to Perform Outpatient Surgery in Public Hospital Waiting List Patients

Hernia in Ambulatory Surgery Centre

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