Return hospital visits and hospital readmissions after ambulatory surgery
Return hospital visits and hospital readmissions after ambulatory surgery
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DOI：
10.1097/00000658-199911000-00016
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发表时间：
1999-11-01
影响因子：
9
通讯作者：
Chung, F
中科院分区：
文献类型：
--
作者：
Mezei, G;Chung, F
目的确定大型门诊手术中心门诊手术后 30 天内的总体再入院率和并发症相关的再入院率。背景数据摘要目前在北美，65% 的外科手术是在门诊环境中进行的。门诊手术的安全性已有充分记录，手术期间或手术后立即发生不良事件的发生率较低。然而，长期门诊手术的后果尚未得到广泛研究。方法收集了在安大略省多伦多一家大型门诊手术中心连续接受门诊手术的 17,638 名患者的术前、术中和术后数据。作者利用安大略省卫生部的数据库，确定了门诊手术后 30 天内安大略省所有回医院就诊和再入院的情况。回访分为急诊室就诊、门诊手术室入院或住院。再入院分为因手术、内科或麻醉相关并发症或与门诊手术无关的并发症。结果门诊手术后 30 天内发生 193 例再入院（再入院率为 1.1%）。 6 名患者返回急诊室，178 名患者重新入院门诊手术室，9 名患者重新入院住院。 25 例再入院是由于手术并发症造成的，1 例是由于医疗并发症（肺栓塞）造成的。并发症相关的再入院率为 0.15%（678 例手术中有 1 例）。接受经尿道膀胱肿瘤切除术的患者并发症发生率明显较高（5.7%）。没有发现与麻醉相关的再入院或死亡。结论 与并发症相关的再入院率极低（0.15%）。这一结果进一步支持了门诊手术是一种安全做法的观点。
ObjectiveTo determine the overall and complication-related readmission rates within 30 days after ambulatory surgery at a major ambulatory surgical center.Summary Background DataCurrently in North America, 65% of the surgical procedures are carried out in ambulatory settings. The safety of ambulatory surgery is well documented, with low rates of adverse events during or immediately after surgery. The consequences of ambulatory surgery during an extended period, however, have not been studied extensively,MethodsPreoperative, intraoperative, and postoperative data were collected on 17,638 consecutive patients undergoing ambulatory surgery at a major ambulatory surgical center in Toronto, Ontario. With the use of the database of the Ontario Ministry of Health, the authors identified all return hospital visits and hospital readmissions occurring in Ontario within 30 days after the ambulatory surgery. Return visits were categorized as emergency room visits, ambulatory surgical unit admissions, or inpatient admissions. The readmissions were categorized as those resulting from surgical, medical, or anesthesia-related complications or those not related to the ambulatory surgery.ResultsOne hundred ninety-three readmissions occurred within 30 days after ambulatory surgery (readmission rate 1.1%). Six patients returned to the emergency room, 178 patients were readmitted to the ambulatory surgical unit, and 9 patients were readmitted as inpatients. Twenty-five readmissions were the result of surgical complications, and one resulted from a medical complication (pulmonary embolism). The complication-related readmission rate was 0.15% (1 in 678 procedures). The complication rate was significantly higher among patients undergoing transurethral resection of bladder tumor (5.7%). No anesthesia-related readmissions or deaths were identified.ConclusionsThe rate of complication-related readmissions was extremely low (0.15%). This result further supports the view that ambulatory surgery is a safe practice.