US ambulatory surgery projections are inappropriate

The Changing Face of Surgery Using Systematic Reviews

Three systematic reviews relating to pre-admission procedures, admission procedures and staffing policies were undertaken to establish evidence to develop best practice guidelines for day surgery units. Results revealed that a pre-admission intervention can improve patient and surgery outcomes, although the most effective type of intervention should be further investigated. It was also found that distraction can reduce patient preoperative anxiety, and there is no high quality evidence relating skill mix, staffing levels and desired health outcomes in day surgery units. Recommendations for areas of future research are presented.

Adverse events and readmissions after day-case urological surgery

OBJECTIVE

The literature lacks of studies on postoperative outcomes after urological ambulatory surgery. Our study aims to identify parameters associated with postoperative complications within 30 days after ambulatory urological surgery.

MATERIALS AND METHODS

Adjusted and unadjusted comparisons between clinical features and postoperative outcome (complicated and uncomplicated).

RESULTS

Postoperative course was complicated in 5% of the patients. Discharge schedule was not completed in 1.1% while unplanned visits resulted in admission in 0.5%. Multivariate analyses could only confirm the independent effect of type of anesthesia and diagnosis-related group (DRG) relative weight.

CONCLUSIONS

Ambulatory urological surgery can be safe in terms of postoperative complications. In the present study surgery under general anesthesia, or a higher DRG relative weight procedure, increased the risk of complications compared to surgery under regional or local anesthesia or lower DRG relative weight operations. Patients scheduled for general anesthesia or undergoing complex urological procedures should be warned about an increased risk of postoperative incidents and/or readmission.